Search › Missouri › 122300000X
Randal Otis, DMD
NPI 1629683925 · on the registry since 2020 · sole proprietor
Practice
- Address
- 650 E 25th St
Kansas City, MO 64108 - Phone
- (816) 235-2177
- Organisation at this address
- Umkc Faculty Practice
Umkc School Of Dentistry
Univ Umkc School Of Dentisty
Curators University Of Missouri
Curator Of The University Of Missouri Umkc Dental School And ClinicsInferred from a shared address, not stated in the registry. - Clinicians at this address
- 84
Additional practice sites
- 938 W Church St, Jasper, GA
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Also registered as
- 1223G0001X
- Licence states on file
- GA, MO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-06-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri