Individual
CODY THRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
Mailing address
PO BOX 5681, SPRINGFIELD, MO 65801-5681
(417) 831-0150
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2014018761
MO
Other
Enumeration date
07/01/2014
Last updated
01/28/2016
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