Individual
STEVEN WESLEY FAWKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
205 SPARTAN DR, RICHMOND, MO 64085
(816) 776-7134
(816) 470-5191
Mailing address
PO BOX 258, RICHMOND, MO 64085
(816) 776-7134
(816) 470-5191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13101
MO
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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