Individual
KENNETH MIKIO OGAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D. , M.D.
Contact information
Practice address
1020 HITT STREET, COLUMBIA, MO 65212-0001
(573) 882-7481
(573) 882-5370
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 882-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
014630
MO
207Q00000X
Family Medicine Physician
Primary
111178
MO
Other
Enumeration date
11/21/2006
Last updated
02/15/2018
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