Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 7077 | NV |
Y | 1223P0221X | Pediatric Dentist | 2020021363 | MO |
N | 1223P0221X | Pediatric Dentist | 37075 | TX |
NPI | 1043751779 |
---|---|
Provider Name | Steven Kent Mann |
First Address | Kansas City, MO 64154-8501 |
Second Address | Prosper, TX 75078-9291 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2017 |
Last Update Date | 21/04/2021 |