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Contact Information

MARY J SUPPASANSATHORN, DDS
7316 RAYTOWN ROAD
RAYTOWN, MO64133
 Phone: 816-353-0140
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for MARY J SUPPASANSATHORN · (Female)

NPI Number 1013076934
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 12/06/2006
Last updated 07/08/2007 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 014840
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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