| Mydentist-joplin | |
|
1411 S Range Line Rd Joplin MO 64801-5589 | |
| (417) 553-7377 | |
| Not Available |
| Full Name | Mydentist-joplin |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1411 S Range Line Rd, Joplin, Missouri |
| Authorized Official Name and Position | Kendra Walker (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175408312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mydentist-joplin 1411 S Range Line Rd Joplin MO 64801-5589 Ph: () - | Mydentist-joplin 1411 S Range Line Rd Joplin MO 64801-5589 Ph: (417) 553-7377 |
| NPI Number | 1306266267 |
|---|---|
| Provider Enumeration Date | 04/18/2014 |
| Last Update Date | 04/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306266267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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