| Smile Dental Associates, Llc | |
|
1620 E Rollins St Moberly MO 65270-2478 | |
| (660) 263-6642 | |
| Not Available |
| Full Name | Smile Dental Associates, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1620 E Rollins St, Moberly, Missouri |
| Authorized Official Name and Position | Kent E Johnson (PRESIDENT) |
| Authorized Official Contact | 6602636642 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Dental Associates, Llc Po Box 306 Moberly MO 65270-0306 Ph: (660) 263-6642 | Smile Dental Associates, Llc 1620 E Rollins St Moberly MO 65270-2478 Ph: (660) 263-6642 |
| NPI Number | 1356716997 |
|---|---|
| Provider Enumeration Date | 12/08/2015 |
| Last Update Date | 12/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356716997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 013322 (Missouri) | Primary |
| 1223G0001X | Dentist - General Practice | 2011015034 (Missouri) | Secondary |
Troy A Hutinger Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1620 E Rollins St, Moberly, MO 65270 Phone: 660-263-6642 | |
Michael W Berry Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 E Rollins St, Moberly, MO 65270 Phone: 660-263-1133 Fax: 660-263-9181 |