Clear Creek Family Dental | |
609 E Wells St Ste F Ash Grove MO 65604-9087 | |
(417) 751-9112 | |
Not Available |
Full Name | Clear Creek Family Dental |
---|---|
Speciality | Dentist - General Practice |
Location | 609 E Wells St Ste F, Ash Grove, Missouri |
Authorized Official Name and Position | Joshua Tanner Rust (PRESIDENT/OWNER) |
Authorized Official Contact | 4177519112 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Clear Creek Family Dental 609 E Wells St Ste F Ash Grove MO 65604-9087 Ph: (417) 751-9112 | Clear Creek Family Dental 609 E Wells St Ste F Ash Grove MO 65604-9087 Ph: (417) 751-9112 |
NPI Number | 1962725184 |
---|---|
Provider Enumeration Date | 03/02/2010 |
Last Update Date | 03/02/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962725184 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 2009013248 (Missouri) | Primary |