Provider Demographics
NPI:1356502041
Name:CALL, KASEY LAWRENCE (DMD)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:LAWRENCE
Last Name:CALL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12565 OAK GROVE LN
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-7291
Mailing Address - Country:US
Mailing Address - Phone:816-728-1412
Mailing Address - Fax:
Practice Address - Street 1:516 NEW MARKET BLVD STE 3
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4014
Practice Address - Country:US
Practice Address - Phone:828-264-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC121811223S0112X
KS606591223S0112X
MO20100080331223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery