| Sikeston Dental Center | |
|
220 Southland Dr Sikeston MO 63801-4403 | |
| (573) 471-4167 | |
| (573) 471-4212 |
| Full Name | Sikeston Dental Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 220 Southland Dr, Sikeston, Missouri |
| Authorized Official Name and Position | Christopher Jones (CEO) |
| Authorized Official Contact | 5737482404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sikeston Dental Center 420 Semo Dr P.o. Box 400 New Madrid MO 63869-1734 Ph: (573) 748-2404 | Sikeston Dental Center 220 Southland Dr Sikeston MO 63801-4403 Ph: (573) 471-4167 |
| NPI Number | 1134340102 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 07/22/2014 |
| Medicare PECOS PAC ID | 6507818044 |
|---|---|
| Medicare Enrollment ID | O20170127001852 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134340102 | NPI | - | NPPES |
| 500704069 | Medicaid | MO | |
| 1134340102 | Other | MO | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
G. Wendell Weathers, D.d.s., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 405 Tanner St, Sikeston, MO 63801 Phone: 573-471-5155 | |
Priggel Family Dentistry Dmd Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 504 Tanner St, Priggel Family Dentistry Dmd Llc, Sikeston, MO 63801 Phone: 573-472-3032 Fax: 573-472-3382 |