Individual
DR. MICHAEL RYAN GREAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1032 CROSSWINDS CT, WENTZVILLE, MO 63385-4836
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2020002303
MO
1223G0001X
General Practice Dentistry
DS041288
PA
Other
Enumeration date
06/07/2017
Last updated
08/13/2020
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