Rolla Family Dentistry Inc

NPI 1154725745 - Dentist - 1223G0001X

NPI Details
NPI 1154725745
Enumeration Date 10/10/2014
Last Updated 10/10/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name JEREMY JEREMY
Position OWNER/PRESIDENT
Phone (573) 364-1599
Fax
Practice Location
1701 E 10TH ST
ROLLA MO, 65401-4601, US
Phone (573) 364-1599
Fax
Business Location
1701 E 10TH ST
ROLLA MO, 65401-4601, US
Phone
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Missouri
License Number 015882
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According to our database, Rolla Family Dentistry Inc NPI is 1154725745, taxonomy code is 1223G0001X and license number is 015882, license state is located at Missouri. Rolla Family Dentistry Inc physically located at 1701 E 10th St, Rolla MO, 65401-4601. NPI Number 1033115704 has the healthcare provider type.

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1154725745 NPI number is provided on an as is basis without warranty of any kind. 1154725745 is maintained by the National Plan & Provider Enumeration System. The contents of Rolla Family Dentistry Inc are for informational purposes only.