| Southern Missouri Community Health Center Dental Clinic | |
|
1137 Independence Dr West Plains MO 65775 | |
| (417) 255-8213 | |
| Not Available |
| Full Name | Southern Missouri Community Health Center Dental Clinic |
|---|---|
| Speciality | Dentist |
| Location | 1137 Independence Dr, West Plains, Missouri |
| Authorized Official Name and Position | Pat Richards (CEO) |
| Authorized Official Contact | 4172558213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Missouri Community Health Center Dental Clinic 1137 Independence Dr West Plains MO 65775 Ph: (417) 255-8213 | Southern Missouri Community Health Center Dental Clinic 1137 Independence Dr West Plains MO 65775 Ph: (417) 255-8213 |
| NPI Number | 1477755544 |
|---|---|
| Provider Enumeration Date | 06/01/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477755544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2004018069 (Missouri) | Secondary |
| 122300000X | Dentist | 2004014784 (Missouri) | Primary |
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