Individual
KEVIN EDWARD MEDLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
834 S ILLINOIS AVE, REPUBLIC, MO 65738
(417) 732-2273
(417) 732-4928
Mailing address
834 S ILLINOIS AVE, REPUBLIC, MO 65738
(417) 732-2273
(417) 732-4928
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE014883
MO
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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