Brick City Dental Llc | |
3612 S Clark St Mexico MO 65265-4104 | |
(573) 581-4352 | |
Not Available |
Full Name | Brick City Dental Llc |
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Speciality | Clinic/center - Dental |
Location | 3612 S Clark St, Mexico, Missouri |
Authorized Official Name and Position | Christopher Kollath (OWNER DENTIST) |
Authorized Official Contact | 9547904438 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Brick City Dental Llc 3612 S Clark St Mexico MO 65265-4104 Ph: (573) 581-4352 | Brick City Dental Llc 3612 S Clark St Mexico MO 65265-4104 Ph: (573) 581-4352 |
NPI Number | 1184389603 |
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Provider Enumeration Date | 11/01/2021 |
Last Update Date | 11/01/2021 |
Identifier | Type | State | Issuer |
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1184389603 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |