Optima Dental Group | |
124 West Main Street Union MO 63084 | |
(636) 583-2612 | |
(636) 583-6479 |
Full Name | Optima Dental Group |
---|---|
Speciality | Dentist |
Location | 124 West Main Street, Union, Missouri |
Authorized Official Name and Position | Michael Q Edwards (OWNER CEO) |
Authorized Official Contact | 6365832612 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Optima Dental Group 124 West Main Street Union MO 63084 Ph: (636) 583-2612 | Optima Dental Group 124 West Main Street Union MO 63084 Ph: (636) 583-2612 |
NPI Number | 1558445221 |
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Provider Enumeration Date | 10/25/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558445221 | NPI | - | NPPES |
2015747 | Other | MO | DELTA DENTAL PLAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | DE015747 (Missouri) | Primary |