Southeast Missouri Health Network | |
111 Prairie Drive East Prairie MO 63845 | |
(573) 649-9311 | |
(573) 649-9331 |
Full Name | Southeast Missouri Health Network |
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Speciality | Dentist |
Location | 111 Prairie Drive, East Prairie, Missouri |
Authorized Official Name and Position | Sara Deane (CFO) |
Authorized Official Contact | 5733132500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Southeast Missouri Health Network 111 Prairie Drive East Prairie MO 63845 Ph: (573) 649-9311 | Southeast Missouri Health Network 111 Prairie Drive East Prairie MO 63845 Ph: (573) 649-9311 |
NPI Number | 1679019491 |
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Provider Enumeration Date | 01/18/2017 |
Last Update Date | 11/09/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679019491 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |