Organization
CUSTOM DENTAL OF HARRISONVILLE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD WASSINK DDS (DENTIST)
(405) 282-6440
Entity
Organization
Contact information
Practice address
2100 N 291 HWY, HARRISONVILLE, MO 64701-1226
(405) 282-6440
(405) 282-6785
Mailing address
2100 N 291 HWY, HARRISONVILLE, MO 64701-1226
(405) 282-6440
(405) 282-6785
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6123
OK
Other
Enumeration date
01/04/2011
Last updated
01/04/2011
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