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402 W Jefferson St Kirksville MO 63501-3407 | |
| (660) 665-2741 | |
| (660) 665-3109 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 402 W Jefferson St, Kirksville, Missouri |
| Authorized Official Name and Position | Andrew H. Grimm (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6606275757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1416 Crown Dr P O Box 1027 Kirksville MO 63501-2548 Ph: (660) 627-5757 | 402 W Jefferson St Kirksville MO 63501-3407 Ph: (660) 665-2741 |
| NPI Number | 1972649986 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 10/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972649986 | NPI | - | NPPES |
| 507477404 | Medicaid | MO |
Kirksville Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1916 N Baltimore St, Kirksville, MO 63501 Phone: 660-665-1901 |