Individual
LUIS FERNANDO MISSURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2541 S 4TH ST, LEAVENWORTH, KS 66048-4512
(913) 346-3636
(913) 346-3636
Mailing address
2541 S 4TH ST, LEAVENWORTH, KS 66048-4512
(913) 346-3636
(913) 346-3636
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10235
CO
1223E0200X
Endodontics
Primary
61501
KS
1223E0200X
Endodontics
DEN.00010235
CO
Other
Enumeration date
08/21/2010
Last updated
07/05/2019
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