Individual
JEREME KEITH SEBASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8291 N BOOTH AVE, KANSAS CITY, MO 64158-7202
(816) 728-2979
Mailing address
2715 N BELLEFONTAINE AVE, KANSAS CITY, MO 64117-2526
(573) 230-3626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2019018946
MO
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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