| Callaway Family Dental Llc | |
|
2424 N Bluff St Fulton MO 65251-2709 | |
| (573) 642-6904 | |
| Not Available |
| Full Name | Callaway Family Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2424 N Bluff St, Fulton, Missouri |
| Authorized Official Name and Position | Alex Madov (MEMBER) |
| Authorized Official Contact | 4028509285 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Callaway Family Dental Llc 2424 N Bluff St Fulton MO 65251-2709 Ph: (573) 642-6904 | Callaway Family Dental Llc 2424 N Bluff St Fulton MO 65251-2709 Ph: (573) 642-6904 |
| NPI Number | 1699484840 |
|---|---|
| Provider Enumeration Date | 11/16/2022 |
| Last Update Date | 11/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699484840 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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