Shamrock Dental Group, Llc | |
2502 William St Suite 2a Cape Girardeau MO 63703-5763 | |
(573) 334-6009 | |
(573) 334-7675 |
Full Name | Shamrock Dental Group, Llc |
---|---|
Speciality | Dentist - General Practice |
Location | 2502 William St, Cape Girardeau, Missouri |
Authorized Official Name and Position | Robert Haberkorn (DENTIST) |
Authorized Official Contact | 5733346009 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Shamrock Dental Group, Llc 2502 William St Suite 2a Cape Girardeau MO 63703-5763 Ph: (573) 334-6009 | Shamrock Dental Group, Llc 2502 William St Suite 2a Cape Girardeau MO 63703-5763 Ph: (573) 334-6009 |
NPI Number | 1831363027 |
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Provider Enumeration Date | 04/17/2008 |
Last Update Date | 04/17/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831363027 | NPI | - | NPPES |
1005255/106930 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 2002031756 (Missouri) | Primary |
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