Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 2017016415 | MO |
NPI | 1063940294 |
---|---|
Provider Name | Dr. Katherine Renee Snodgrass |
First Address | Lees Summit, MO 64064-3101 |
Second Address | Buckner, MO 64016-8142 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2017 |
Last Update Date | 01/06/2017 |