| Missouri Smiles Llc | |
|
3621 Discovery Parkway Ste 101 Columbia MO 65201 | |
| (573) 424-2067 | |
| Not Available |
| Full Name | Missouri Smiles Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3621 Discovery Parkway, Columbia, Missouri |
| Authorized Official Name and Position | Kyle Lisenby (DENTIST OWNER) |
| Authorized Official Contact | 5734242067 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Missouri Smiles Llc 2102 Port Townsend Ct Columbia MO 65203-1014 Ph: (573) 424-2067 | Missouri Smiles Llc 3621 Discovery Parkway Ste 101 Columbia MO 65201 Ph: (573) 424-2067 |
| NPI Number | 1508549130 |
|---|---|
| Provider Enumeration Date | 08/10/2023 |
| Last Update Date | 08/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508549130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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