Most Relevant Information
Provider Data
| NPI Number: | 1003266966 |
| Provider Name: | LORENZO KIDD NEILSEN D.D.S. |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 61219 |
Most Important Dates
| Enumeration Date: | 06/21/2016 |
| Last Updated: | 08/07/2016 |
Provider Practice Location
2033 SW STERLING DR
LEES SUMMIT
MO
640814040
Practice Location Phone/Fax
| Phone: | 8018912043 |
| Fax: | 9134512959 |
Provider Mailing Location
2033 SW STERLING DR
LEES SUMMIT
MO
640814040
Provider Mailing Phone/Fax
| Phone: | 8018912043 |
| Fax: | 9134512959 |