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General NPI Number Information
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NPI Number | 1437392701
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Entity Type | Individual
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Provider Name | AIME BROYLES D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/15/2009
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 680 SE BAYBERRY LN SUITE 105
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City | LEES SUMMIT
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State | MO
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Zip | 64063-4386
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Country | US
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Telephone | 816-525-5257
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Fax | 816-525-6050
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Provider Business Mailing Address
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Address Line | 680 SE BAYBERRY LN SUITE 105
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City | LEES SUMMIT
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State | MO
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Zip | 64063-4386
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Country | US
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Telephone | 816-525-5257
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Fax | 816-525-6050
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6970
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2007037234
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License Number State | MO
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