Provider Demographics
NPI:1891760880
Name:UNSELL, MICKEY LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:MICKEY
Middle Name:LEE
Last Name:UNSELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1218 NE WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5594
Mailing Address - Country:US
Mailing Address - Phone:816-554-7668
Mailing Address - Fax:816-554-7651
Practice Address - Street 1:1218 NE WINDSOR DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5594
Practice Address - Country:US
Practice Address - Phone:816-554-7668
Practice Address - Fax:816-554-7651
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0150671223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics