| Kahoka Dental | |
|
22291 Us Highway 136 Kahoka MO 63445 | |
| (660) 727-1500 | |
| (660) 727-1502 |
| Full Name | Kahoka Dental |
|---|---|
| Speciality | Dentist |
| Location | 22291 Us Highway 136, Kahoka, Missouri |
| Authorized Official Name and Position | Andrew Grimm (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6606275757 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kahoka Dental 1416 Crown Dr Kirksville MO 63501-2548 Ph: (660) 627-5757 | Kahoka Dental 22291 Us Highway 136 Kahoka MO 63445 Ph: (660) 727-1500 |
| NPI Number | 1457634594 |
|---|---|
| Provider Enumeration Date | 09/26/2011 |
| Last Update Date | 01/17/2022 |
| Medicare PECOS PAC ID | 1658280805 |
|---|---|
| Medicare Enrollment ID | O20170824002340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457634594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | 2007014537 (Missouri) | Primary |
Lynne E Barbour Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 E Commercial, Kahoka, MO 63445 Phone: 660-727-4746 Fax: 660-727-4747 |