Individual
DR. JUSTIN HUMMELGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
103 S 36TH ST, SAINT JOSEPH, MO 64506-2920
(816) 364-1186
Mailing address
103 S 36TH ST, SAINT JOSEPH, MO 64506-2920
(816) 364-1186
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2020020655
MO
1223G0001X
General Practice Dentistry
61697
KS
Other
Enumeration date
06/03/2020
Last updated
08/22/2023
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