Provider Demographics
NPI:1821321712
Name:MUEHLEBACH, LAWRENCE D (DDS)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:D
Last Name:MUEHLEBACH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16770 VILLAGE DR.
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012
Mailing Address - Country:US
Mailing Address - Phone:816-863-2311
Mailing Address - Fax:816-318-9516
Practice Address - Street 1:400 E RED BRIDGE RD STE 119
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-4029
Practice Address - Country:US
Practice Address - Phone:816-863-2311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0131391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice