Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 2002002702 | MO |
NPI | 1063520054 |
---|---|
Provider Name | Dr. Carrie Kiefer Arquitt |
First Address | Springfield, MO 65806-2203 |
Second Address | Springfield, MO 65806-1102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 09/07/2007 |