Individual
SPENCER WESLEY MULLENAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12414 S US HIGHWAY 71, GRANDVIEW, MO 64030-1733
(816) 307-7000
Mailing address
810 EVE ORCHID DR, GREENWOOD, MO 64034-7802
(928) 651-5971
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2020014068
MO
Other
Enumeration date
04/10/2018
Last updated
07/01/2023
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