| Hormozdi D.d.s. Denture Clinic, Pc | |
|
5950 N Oak Trfy Ste 101 Gladstone MO 64118-5164 | |
| (816) 298-0090 | |
| Not Available |
| Full Name | Hormozdi D.d.s. Denture Clinic, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5950 N Oak Trfy Ste 101, Gladstone, Missouri |
| Authorized Official Name and Position | Tyrena L. Bell (OFFICE MANAGER) |
| Authorized Official Contact | 8162980090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hormozdi D.d.s. Denture Clinic, Pc 5950 N Oak Trfy Ste 101 Gladstone MO 64118-5164 Ph: (816) 298-0090 | Hormozdi D.d.s. Denture Clinic, Pc 5950 N Oak Trfy Ste 101 Gladstone MO 64118-5164 Ph: (816) 298-0090 |
| NPI Number | 1235647850 |
|---|---|
| Provider Enumeration Date | 01/17/2018 |
| Last Update Date | 01/17/2018 |
| Medicare PECOS PAC ID | 1951796788 |
|---|---|
| Medicare Enrollment ID | O20220315000295 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235647850 | NPI | - | NPPES |
| 1871853853 | Other | MO | DENTIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2012015475 (Missouri) | Primary |
| Provider Name | Hormoz Hormozdi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1871853853 PECOS PAC ID: 2860887692 Enrollment ID: I20220315000355 |
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