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3320 Bluff Creek Dr Suite 100 Columbia MO 65201-3501 | |
| (573) 875-5336 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3320 Bluff Creek Dr, Columbia, Missouri |
| Authorized Official Name and Position | Johnathan L Mallott (PRESIDENT) |
| Authorized Official Contact | 5738755336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3320 Bluff Creek Dr Suite 100 Columbia MO 65201-3501 Ph: (573) 875-5336 | 3320 Bluff Creek Dr Suite 100 Columbia MO 65201-3501 Ph: (573) 875-5336 |
| NPI Number | 1457732208 |
|---|---|
| Provider Enumeration Date | 06/17/2015 |
| Last Update Date | 06/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457732208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2003102136 (Missouri) | Primary |
Michael S. Todd D.m.d., Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Vandiver Dr, Suite 104, Columbia, MO 65202 Phone: 573-814-1694 Fax: 573-814-2845 | |
Plaza Dental Implant & Surgical Center, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 N Keene St, Suite 209, Columbia, MO 65201 Phone: 573-817-2220 Fax: 573-817-2808 | |
Steven E. Taylor Dds Ms Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 Forum Blvd, Suite 12, Columbia, MO 65203 Phone: 573-446-7259 |