| Shell Knob Dental Center | |
|
25376 State Highway 39 Suite 201 Shell Knob MO 65747-7343 | |
| (417) 858-6527 | |
| Not Available |
| Full Name | Shell Knob Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 25376 State Highway 39, Shell Knob, Missouri |
| Authorized Official Name and Position | Brian K. Leach (OWNER/DENTIST) |
| Authorized Official Contact | 4178586527 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shell Knob Dental Center Po Box 226 Shell Knob MO 65747-0226 Ph: (417) 858-6527 | Shell Knob Dental Center 25376 State Highway 39 Suite 201 Shell Knob MO 65747-7343 Ph: (417) 858-6527 |
| NPI Number | 1629468103 |
|---|---|
| Provider Enumeration Date | 02/04/2015 |
| Last Update Date | 02/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629468103 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2009011494 (Missouri) | Primary |
Shell Knob Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 25376 State Highway 39, Suite 201, Shell Knob, MO 65747 Phone: 417-858-6527 Fax: 417-858-2570 |