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Individual

MRS. JASMINE WYATT GRIECHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
802 E WALNUT ST, BELTON, MO 64012-2544
(816) 322-7600
(816) 322-7606
Mailing address
710 SW MISTY GLN, GRAIN VALLEY, MO 64029-2500
(816) 322-7600
(816) 322-7606

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
2009024711
MO
124Q00000X
Dental Hygienist
Primary
RDH22749
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1477563518
CA
05
FHC70081F
CA
Enumeration date
01/30/2008
Last updated
06/20/2011
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