| Demaree Mitchell Family Dentistry Llc | |
|
851 W Grant St Dexter MO 63841-2430 | |
| (573) 624-8005 | |
| Not Available |
| Full Name | Demaree Mitchell Family Dentistry Llc |
|---|---|
| Speciality | Dentist |
| Location | 851 W Grant St, Dexter, Missouri |
| Authorized Official Name and Position | Kevin Wayne Mitchell (DENTIST) |
| Authorized Official Contact | 5736248005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Demaree Mitchell Family Dentistry Llc 851 W Grant St P.o. Box 488 Dexter MO 63841-2430 Ph: (573) 624-8005 | Demaree Mitchell Family Dentistry Llc 851 W Grant St Dexter MO 63841-2430 Ph: (573) 624-8005 |
| NPI Number | 1023349065 |
|---|---|
| Provider Enumeration Date | 01/14/2010 |
| Last Update Date | 01/14/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023349065 | NPI | - | NPPES |
| 403047012 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 15266 (Missouri) | Primary |
Professional Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 913 West Business Highway 60, Dexter, MO 63841 Phone: 573-624-7456 Fax: 573-624-5182 |