Provider Demographics
NPI:1194086397
Name:MISSURA, ALLYSON KARINA (DDS)
Entity type:Individual
Prefix:DR
First Name:ALLYSON
Middle Name:KARINA
Last Name:MISSURA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ALLYSON
Other - Middle Name:KARINA
Other - Last Name:SUNDBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1613 BROOKDALE DR
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-1198
Mailing Address - Country:US
Mailing Address - Phone:913-360-3819
Mailing Address - Fax:
Practice Address - Street 1:222 N 7TH ST
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-2427
Practice Address - Country:US
Practice Address - Phone:913-360-3819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60775122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist