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168 S. Payne Stewart Dr. Ste 100 Branson MO 65616 | |
| (417) 335-4746 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 168 S. Payne Stewart Dr., Branson, Missouri |
| Authorized Official Name and Position | Mark Dake (MEMBER) |
| Authorized Official Contact | 4172565100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
168 S Payne Stewart Dr Ste 100 Branson MO 65616 Ph: (417) 335-4746 | 168 S. Payne Stewart Dr. Ste 100 Branson MO 65616 Ph: (417) 335-4746 |
| NPI Number | 1164864336 |
|---|---|
| Provider Enumeration Date | 07/29/2013 |
| Last Update Date | 07/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164864336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
Gentle Dental Centers Of The Ozrks, Llc Brett D Wyman Sole Member Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 827 W Main St Ste 202, Branson, MO 65616 Phone: 417-334-7400 Fax: 417-335-3942 | |
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