| Fairview Dental Care | |
|
2901 W Broadway Ste 109 Columbia MO 65203-0669 | |
| (573) 445-5811 | |
| (573) 445-5819 |
| Full Name | Fairview Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2901 W Broadway Ste 109, Columbia, Missouri |
| Authorized Official Name and Position | Kendra Walker (CREDENTIALING TEAM LEAD) |
| Authorized Official Contact | 2175408513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairview Dental Care 2901 W Broadway Ste 109 Columbia MO 65203-0669 Ph: (573) 445-5811 | Fairview Dental Care 2901 W Broadway Ste 109 Columbia MO 65203-0669 Ph: (573) 445-5811 |
| NPI Number | 1558669556 |
|---|---|
| Provider Enumeration Date | 03/01/2011 |
| Last Update Date | 04/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558669556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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