| Copper Creek Dental | |
|
797 W South St Ozark MO 65721-9261 | |
| (417) 581-0835 | |
| Not Available |
| Full Name | Copper Creek Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 797 W South St, Ozark, Missouri |
| Authorized Official Name and Position | Jonathan W Jacoby (DENTIST) |
| Authorized Official Contact | 8168637096 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Copper Creek Dental 119 Jared Blvd Webb City MO 64870-9214 Ph: (816) 863-7096 | Copper Creek Dental 797 W South St Ozark MO 65721-9261 Ph: (417) 581-0835 |
| NPI Number | 1104319862 |
|---|---|
| Provider Enumeration Date | 06/07/2018 |
| Last Update Date | 06/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104319862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2015016758 (Missouri) | Primary |
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