| Mid Missouri Dental Center | |
|
1500 Vandiver Dr Suite 104 Columbia MO 65202-3932 | |
| (573) 814-1694 | |
| (573) 814-2845 |
| Full Name | Mid Missouri Dental Center |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1500 Vandiver Dr, Columbia, Missouri |
| Authorized Official Name and Position | Kerri L Smith (OFFICE MANAGER) |
| Authorized Official Contact | 5738141694 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Missouri Dental Center 1500 Vandiver Dr Suite 104 Columbia MO 65202-3932 Ph: (573) 814-1694 | Mid Missouri Dental Center 1500 Vandiver Dr Suite 104 Columbia MO 65202-3932 Ph: (573) 814-1694 |
| NPI Number | 1164622395 |
|---|---|
| Provider Enumeration Date | 07/25/2007 |
| Last Update Date | 07/25/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164622395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 010435 (Missouri) | Primary |
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