Organization
DOUGLAS A WYCKOFF DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS ALLEN WYCKOFF DDS PC (OWNER)
(816) 632-2822
Entity
Organization
Contact information
Practice address
1801 N WALNUT, CAMERON, MO 64429
(816) 632-2822
(816) 632-5245
Mailing address
PO BOX 464, CAMERON, MD 64429
(816) 632-2822
(816) 632-5245
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
015416
MO
Other
Enumeration date
08/07/2007
Last updated
08/07/2007
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