Individual
DR. LIYA M KUNNASSERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
220 SOUTHLAND DR, SIKESTON, MO 63801-4403
(573) 471-4167
(573) 471-4212
Mailing address
420 SEMO DR, NEW MADRID, MO 63869-1734
(573) 748-2404
(573) 748-2554
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.027987
IL
122300000X
Dentist
Primary
2011039208
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467684183
—
MO
Enumeration date
08/13/2009
Last updated
11/26/2013
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