Organization
MIDWESTPERIODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVE SOUTHARD DDS (PRESIDENT)
(816) 390-2500
Entity
Organization
Contact information
Practice address
1006 W SAINT MAARTENS DR, SUITE A, SAINT JOSEPH, MO 64506-2966
(816) 364-3325
Mailing address
1006 W SAINT MAARTENS DR, SUITE A, SAINT JOSEPH, MO 64506-2966
(816) 364-3325
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
14401
MO
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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