Individual
GARRETT S SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1166 GREENWAY DR STE A1, JACKSON, MO 63755-2919
(573) 204-8300
Mailing address
2539 RIDGE RD, JACKSON, MO 63755-1619
(573) 204-1126
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2001018213
MO
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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