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Individual

DR. RYAN MITCHELL WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
803 N 36TH ST, SUITE C, SAINT JOSEPH, MO 64506-2970
(816) 364-4422
(816) 364-1122
Mailing address
803 N 36TH ST, SUITE C, SAINT JOSEPH, MO 64506-2970
(816) 364-4422
(816) 364-1122

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
2003011564
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11564
DELTA DENTAL
01
33866024
BLUE CROSS & BLUE SHIELD
MO
Enumeration date
10/26/2006
Last updated
07/08/2007
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