Individual
KELLY MITCHELL LINEBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
407 CLAIRBORNE, SUITE 200, OLATHE, KS 66062
(913) 782-8838
(913) 782-6776
Mailing address
407 CLAIRBORNE, SUITE 200, OLATHE, KS 66062
(913) 782-8838
(913) 782-6776
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6568
KS
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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