Individual
ERIC KAPUSTKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
125 JOHNSTOWN DR, ROGERSVILLE, MO 65742-9366
(417) 753-2963
(417) 753-3543
Mailing address
125 JOHNSTOWN DR, ROGERSVILLE, MO 65742-9366
(417) 753-2963
(417) 753-3543
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14426
MO
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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