Individual
BRIANNA MICHELE GANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
11225 NALL AVE, SUITE 100, LEAWOOD, KS 66211-1928
(913) 469-6555
(913) 469-6555
Mailing address
11225 NALL AVE, SUITE 100, LEAWOOD, KS 66211-1928
(913) 469-6555
(913) 469-6555
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2014004314
MO
1223G0001X
General Practice Dentistry
Primary
60829
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235494964
—
MO
05
—
201112750A
—
KS
05
—
40012248
—
MO
Enumeration date
07/09/2012
Last updated
12/08/2020
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