Individual
MADISON DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
811 S BUSINESS HIGHWAY 13 STE A, LEXINGTON, MO 64067-1572
(660) 251-6440
Mailing address
4911 MERCIER ST, KANSAS CITY, MO 64112-1308
(913) 633-0061
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2021019490
MO
Other
Enumeration date
06/07/2021
Last updated
01/17/2024
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