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General NPI Number Information
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NPI Number | 1902581283
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Entity Type | Organization
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Legal Business Name | KMAPLES ENTERPRISES LLC
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 187 ROCKHILL DRIVE SUITE 4
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City | FORSYTH
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State | MO
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Zip | 65653
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Country | US
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Telephone | 417-251-9179
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1239
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City | FORSYTH
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State | MO
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Zip | 65653-1239
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Country | US
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Telephone | 417-251-9179
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF MEDICAL DENTISTRY
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Name | DR. JEFFREY KYLE MAPLES
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Credential | DMD
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Telephone | 417-496-0547
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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 |
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License Number State |
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