Individual
DR. IBUKUN T AKINYEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
215 WALNUT STREET, ELLINGTON, MO 63638-0157
(573) 323-0423
(573) 323-8931
Mailing address
PO BOX 157, ELLINGTON, MO 63638-0157
(573) 323-0423
(573) 323-8931
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019028433
IL
1223G0001X
General Practice Dentistry
Primary
2011017343
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215240072
—
MO
Enumeration date
07/22/2010
Last updated
02/08/2012
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