Individual
MICHELLE N. PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
825 EUCLID AVE, KANSAS CITY, MO 64124-2323
(816) 474-4920
(816) 474-4914
Mailing address
825 EUCLID AVE, KANSAS CITY, MO 64124-2323
(816) 474-4920
(816) 474-4914
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2011001777
MO
1223G0001X
General Practice Dentistry
60589
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002063585
UNITED CONCORIDA
KS
05
—
1073779633
—
MO
05
—
200579650A
—
KS
01
—
C16000067
PTAN
MO
Enumeration date
08/04/2008
Last updated
09/28/2016
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