Individual
STACI NICOLE OSGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2016 S BROADWAY # 8439, OAK GROVE, MO 64075-8439
(816) 690-7757
Mailing address
2016 S BROADWAY # 8439, OAK GROVE, MO 64075-8439
(913) 558-3919
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2017030487
MO
Other
Enumeration date
08/30/2017
Last updated
07/01/2021
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