Dental Depot of Independence, Pllc
NPI #1568193449 in Independence, Missouri
Provider Information
- NPI Number
- 1568193449
- Entity Type
- Organization
- Organization Name
- Dental Depot of Independence, Pllc
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Jun 21, 2022
- Last Updated
- Jun 21, 2022
Practice Location
- Address
- 16801 E US HIGHWAY 24
- City
- Independence
- State
- Missouri
- ZIP Code
- 64056-1529
- Phone
- (816) 750-1345
Authorized Official
- Name
- GAYLON ZISSA
- Title
- DIRECTOR OF PROVIDER RELATIONS
- Phone
- (405) 409-3789
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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