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General NPI Number Information
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NPI Number | 1790899102
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Entity Type | Organization
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Legal Business Name | TINSLEY & SHULTZ DDS PC
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 2 WESTWOODS DR
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City | LIBERTY
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State | MO
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Zip | 64068-3519
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Country | US
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Telephone | 816-781-1430
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Fax | 816-781-7895
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Provider Business Mailing Address
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Address Line | 2 WESTWOODS DR
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City | LIBERTY
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State | MO
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Zip | 64068-3519
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Country | US
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Telephone | 816-781-1430
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Fax | 816-781-7895
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MS. CYNTHIA SHEPHERD
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Credential |
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Telephone | 816-781-1430
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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 | 014869
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License Number State | MO
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