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Individual

DR. ROBERT L ENNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
3916 S. LYNN CT., INDEPENDENCE, MO 64055
(816) 254-2345
(816) 254-1579
Mailing address
3916 S LYNN CT, INDEPENDENCE, MO 64055-3393
(816) 254-2345
(816) 254-1579

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
11438
MO

Other

Enumeration date
09/26/2006
Last updated
05/05/2015
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