Individual
AREZO HESARAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2016 S BROADWAY, OAK GROVE, MO 64075-8439
(816) 690-4141
Mailing address
1050 W 10TH ST, STE 480, ROLLA, MO 65401-2905
(816) 690-4141
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2014031462
MO
1223G0001X
General Practice Dentistry
61113
KS
Other
Enumeration date
10/23/2014
Last updated
10/02/2024
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