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Individual

DUSTIN KYLE VANDOLAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2301 HOLMES ST, KANSAS CITY, MO 64108-2640
(816) 404-1000
Mailing address
2301 HOLMES ST, KANSAS CITY, MO 64108-2640
(816) 404-1000

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2011011371
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
204394407
MO
Enumeration date
04/26/2007
Last updated
12/23/2020
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