Organization
DENTAL DEPOT OF BLUE SPRINGS PLLC
Active
Other names
Dental Depot of Blue Springs PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLON ZISSA (PROFESSIONAL RELATIONS MANAGER)
(405) 945-8941
Entity
Organization
Contact information
Practice address
1500 S 7 HWY, BLUE SPRINGS, MO 64014-3943
(816) 295-7927
(816) 874-6812
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(816) 295-7927
(816) 874-6812
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/13/2020
Last updated
06/25/2021
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