| Capital Dentistry For Children Llc | |
|
931 Wildwood Dr Ste 104 Jefferson City MO 65109-5719 | |
| (573) 874-1990 | |
| Not Available |
| Full Name | Capital Dentistry For Children Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 931 Wildwood Dr Ste 104, Jefferson City, Missouri |
| Authorized Official Name and Position | Robert Dale Coyle (OWNER/MEMBER) |
| Authorized Official Contact | 5738741990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital Dentistry For Children Llc 1000 W. Nifong Blvd., Bldg 6, Suite 130 Columbia MO 65203 Ph: (573) 874-1990 | Capital Dentistry For Children Llc 931 Wildwood Dr Ste 104 Jefferson City MO 65109-5719 Ph: (573) 874-1990 |
| NPI Number | 1740627447 |
|---|---|
| Provider Enumeration Date | 06/04/2013 |
| Last Update Date | 06/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740627447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 016056 (Missouri) | Primary |
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