Individual
ANGELINA BANAKH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DH
Contact information
Practice address
821 WESTWOOD DR, SEDALIA, MO 65301-2102
(660) 826-4774
(660) 826-1300
Mailing address
821 WESTWOOD DRIVE, SEDALIA, MO 65301-2102
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2015016301
MO
Other
Enumeration date
07/24/2015
Last updated
07/24/2015
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