Whalio Doctors

NPI 1285613240

Matthew R Hlavacek, MDDDS

Practitioner Oral & Maxillofacial Surgery (D.M.D.) Lees Summit, MO

Practice location

Address
1208 NE Windsor Dr, Lees Summit, MO 64086-5594
Phone
(816) 524-4334
Fax
(816) 524-4399

Registered specialties (4)

Oral & Maxillofacial Surgery (D.M.D.) Primary
Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 2005027155 (MO)
Oral and Maxillofacial Surgery (Dentist)
Dental Providers Taxonomy 1223S0112X Licence 016083 (MO)
General Practice Physician
Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 2005027155 (MO)
Dentist
Dental Providers Taxonomy 122300000X Licence 016083 (MO)

Registry record

NPI
1285613240
Entity type
Individual
Sex (as registered)
Male
NPI issued
10 Jan 2006
Record last updated
30 Jul 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.