Individual
JEREMY J YOUNGBLOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6301 N OAK TRFY, SUITE 102, KANSAS CITY, MO 64118-4705
(816) 453-2323
(816) 453-3130
Mailing address
6301 N OAK TRFY, SUITE 102, KANSAS CITY, MO 64118-4705
(816) 453-2323
(816) 453-3130
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
013891
MO
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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