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Individual

DR. SCOTT WAYNE HERIFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
110 W DRYDEN ST, ODESSA, MO 64076-1217
(816) 230-4813
(816) 633-4255
Mailing address
110 W DRYDEN ST, ODESSA, MO 64076-1217
(816) 230-4813
(816) 633-4255

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
015198
MO

Other

Enumeration date
04/20/2007
Last updated
07/08/2007
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