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Stas Vidyakin, DMD
General Practice Dentistry in Sikeston, Missouri
NPI 1285292193

Stas Vidyakin is a General Practice Dentistry based in Benton, MO and is specialized in General Practice. Stas Vidyakin practices in Sikeston, MO and has the professional credentials of DMD. The NPI Number for Stas Vidyakin is 1285292193 and holds a License No. 2019019577 (Missouri).

The current practice location address for Stas Vidyakin is 220 Southland Dr, Sikeston, MO and can be reached out via phone at 573-471-4167 and via fax at 573-471-4212.

Location: 220 Southland Dr, Sikeston, MO, 63736-8238
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1285292193
Provider Name
Stas Vidyakin
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
220 Southland Dr, Sikeston, MO, 63736-8238
Phone Number
573-471-4167
Fax Number
573-471-4212
Provider Enumeration Date
06/05/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
400070483 05 MO
institution
Provider Business Practice Location Address Details
Address
220 Southland Dr
City
Sikeston
State
Missouri
Zip
63801-4403
Phone Number
573-471-4167
Fax Number
573-471-4212
person
Provider Business Mailing Address Details
Address
220 Southland Dr
City
Sikeston
State
Missouri
Zip
63801-4403
Phone Number
573-471-4167
Fax Number
573-471-4212
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
2019019577 (Missouri)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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