Individual
DR. MELISSA E KUSIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7311 W 79TH ST, OVERLAND PARK, KS 66204-2908
(913) 269-2088
Mailing address
7311 W 79TH ST, OVERLAND PARK, KS 66204-2908
(913) 269-2088
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
60886
KS
1223G0001X
General Practice Dentistry
Primary
60886
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200751760B
—
KS
Enumeration date
10/11/2011
Last updated
10/22/2014
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