Individual provider · NPI-1

Dr. Adegbenga Adeolu Adepoju, DMD

Dentist, General Practice · Springfield, MO

NPI number1437687928
StatusActive
Last updated in NPPESMay 26, 2017

Details

NPI
1437687928
Entity type
Individual (NPI-1)
Name
Dr. Adegbenga Adeolu Adepoju
Credential
DMD
Sex
Male
Sole proprietor
No
Enumeration date
May 26, 2017
Last updated
May 26, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice2017015988MOYes

Practice location

3842 S Glenstone Ave
Springfield, MO 65804-4418

Phone 417-612-7109

Mailing address

2120 E Lakewood St
Springfield, MO 65804-7585

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