Individual
DR. LON ROLAND TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
300 S. INDEPENDENCE STREET, HARRISONVILLE, MO 64701
(816) 380-6000
(816) 380-6000
Mailing address
P.O. BOX 549, HARRISONVILLE, MO 64701
(816) 380-6000
(816) 380-6000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
014713
MO
1223G0001X
General Practice Dentistry
Primary
14713
MO
Other
Enumeration date
02/20/2013
Last updated
06/05/2018
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