Individual
TRENT LYLE PAYNE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
331 SIJEN AVE, WHITEMAN AFB, MO 65305-1269
(660) 687-2201
Mailing address
1603 AMHEARST ST, WARRENSBURG, MO 64093-2983
(660) 747-6066
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15260
TX
Other
Enumeration date
08/31/2005
Last updated
07/08/2007
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