| Mbd Merger Llc | |
|
1736 Broadway Cape Girardeau MO 63701 | |
| (573) 334-5755 | |
| (573) 334-1501 |
| Full Name | Mbd Merger Llc |
|---|---|
| Speciality | Dentist |
| Location | 1736 Broadway, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Nathan G. Mcguire (ORTHODONTIST/MEMBER) |
| Authorized Official Contact | 5733345755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mbd Merger Llc 1736 Broadway Cape Girardeau MO 63701 Ph: (573) 334-5755 | Mbd Merger Llc 1736 Broadway Cape Girardeau MO 63701 Ph: (573) 334-5755 |
| NPI Number | 1477824662 |
|---|---|
| Provider Enumeration Date | 01/19/2012 |
| Last Update Date | 01/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477824662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2006015824 (Missouri) | Primary |
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