Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 2020023718 | MO |
NPI | 1215301916 |
---|---|
Provider Name | Dr. Christian Vargas |
First Address | Grain Valley, MO 64029-8424 |
Second Address | Lexington, MO 64067-1572 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2015 |
Last Update Date | 30/07/2020 |