| Grand Dental Studio Llc | |
|
948 S Jefferson Ave Springfield MO 65806-3204 | |
| (417) 861-8876 | |
| Not Available |
| Full Name | Grand Dental Studio Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 948 S Jefferson Ave, Springfield, Missouri |
| Authorized Official Name and Position | Nicholas R Matthews (OWNER/DENTIST) |
| Authorized Official Contact | 4178658405 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Dental Studio Llc 948 S Jefferson Ave Springfield MO 65806-3204 Ph: (417) 865-8405 | Grand Dental Studio Llc 948 S Jefferson Ave Springfield MO 65806-3204 Ph: (417) 861-8876 |
| NPI Number | 1992432447 |
|---|---|
| Provider Enumeration Date | 08/04/2022 |
| Last Update Date | 03/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992432447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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