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Organization
DENTAL DEPOT OF LEES SUMMIT, PLLC
Active
Organization
DENTAL DEPOT OF LEES SUMMIT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLON ZISSA (DIRECTOR OF PROVIDER RELATIONS)
(405) 945-8941
Entity
Organization
Contact information
Practice address
1501 NE RICE ROAD, LEES SUMMIT, MO 64086
(816) 402-3123
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(405) 945-8941
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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