Individual
MICHAEL C KNIERIM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
805 MAIN, PLEASANTON, KS 66075
(913) 352-8503
(913) 352-8440
Mailing address
PO BOX 467, 805 MAIN, PLEASANTON, KS 66075
(913) 352-8503
(913) 352-8440
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5805
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1005548
HEALTH GUARD TILLE 21
KS
01
—
116665
BCBS OF KS
KS
Enumeration date
06/13/2006
Last updated
07/08/2007
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