Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 013178 | MO |
NPI | 1265479885 |
---|---|
Provider Name | Dr. Donna N Deines |
First Address | Kansas City, MO 64113-2224 |
Second Address | Kansas City, MO 64113-2224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 08/07/2007 |