| The Colonies Dental Center | |
|
2516 Forum Blvd Suite #200 Columbia MO 65203-5405 | |
| (573) 446-6662 | |
| (573) 446-6660 |
| Full Name | The Colonies Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 2516 Forum Blvd, Columbia, Missouri |
| Authorized Official Name and Position | Eric Roger Boyd (PRESIDENT) |
| Authorized Official Contact | 5734466662 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Colonies Dental Center 2516 Forum Blvd Suite #200 Columbia MO 65203-5405 Ph: (573) 446-6662 | The Colonies Dental Center 2516 Forum Blvd Suite #200 Columbia MO 65203-5405 Ph: (573) 446-6662 |
| NPI Number | 1053608901 |
|---|---|
| Provider Enumeration Date | 06/29/2011 |
| Last Update Date | 06/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053608901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2009028398 (Missouri) | Primary |
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