Most Relevant Information
Provider Data
| NPI Number: | 1003295460 |
| Provider Name: | KYRA J TRACY RDH |
| Entity Type: | Individual |
| Taxonomy Code: | 124Q00000X |
| Specialty: | Dental Hygienist |
| License Number: | 2013010347 |
Most Important Dates
| Enumeration Date: | 05/19/2015 |
| Last Updated: | 05/19/2015 |
Provider Practice Location
608 S MISSOURI ST.
WAVERLY
MO
64096
Practice Location Phone/Fax
| Phone: | 6604932262 |
| Fax: | 6604932796 |
Provider Mailing Location
608 S. MISSOURI ST.
WAVERLY
MO
64096
Provider Mailing Phone/Fax
| Phone: | 6604932262 |
| Fax: | 6604932796 |