Individual
MRS. TYESHA DAWN MARIE DENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10015 N AMBASSADOR DR, KANSAS CITY, MO 64153-1364
(816) 595-4000
(701) 584-3011
Mailing address
19680 BLUE JAY TRAIL CIR, LAWSON, MO 64062-7032
(701) 209-0350
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2021036928
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11228
—
ND
01
—
28537
BLUE CROSS BLUE SHIELD
ND
Enumeration date
02/05/2007
Last updated
09/22/2024
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