| Forum Dental | |
|
1810 E 10th St Rolla MO 65401-4603 | |
| (573) 364-1821 | |
| Not Available |
| Full Name | Forum Dental |
|---|---|
| Speciality | Dentist |
| Location | 1810 E 10th St, Rolla, Missouri |
| Authorized Official Name and Position | Christy Burke (OFFICE MANAGER) |
| Authorized Official Contact | 5733641821 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forum Dental 1810 E 10th St Rolla MO 65401-4603 Ph: (573) 364-1821 | Forum Dental 1810 E 10th St Rolla MO 65401-4603 Ph: (573) 364-1821 |
| NPI Number | 1033305511 |
|---|---|
| Provider Enumeration Date | 09/19/2007 |
| Last Update Date | 09/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033305511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE13190 (Missouri) | Primary |
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