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General NPI Number Information
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NPI Number | 1548262256
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Entity Type | Individual
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Provider Name | KENT L GRASSLE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 507 N MUR LEN RD
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City | OLATHE
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State | KS
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Zip | 66062-1267
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Country | US
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Telephone | 913-782-0873
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Fax | 913-782-8477
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Provider Business Mailing Address
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Address Line | 10425 MASTIN ST APT. D
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City | OVERLAND PARK
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State | KS
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Zip | 66212-5703
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Country | US
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Telephone | 913-599-4023
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 5976
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License Number State | KS
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