Individual
MANUELA AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1205 NE CORONADO DR, BLUE SPRINGS, MO 64014-2928
(816) 228-4090
Mailing address
117 W 20TH ST APT 409, KANSAS CITY, MO 64108-2080
(915) 497-5338
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2018043082
MO
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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