| Bolivar Smiles Dentistry, Llc | |
|
1300 N Oakland Ave Ste B Bolivar MO 65613-3008 | |
| (417) 326-6061 | |
| (417) 326-3537 |
| Full Name | Bolivar Smiles Dentistry, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1300 N Oakland Ave Ste B, Bolivar, Missouri |
| Authorized Official Name and Position | Chad Louis Guerra (OWNER) |
| Authorized Official Contact | 4173263537 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bolivar Smiles Dentistry, Llc 1300 N Oakland Ave Ste B Bolivar MO 65613-3008 Ph: (417) 326-6061 | Bolivar Smiles Dentistry, Llc 1300 N Oakland Ave Ste B Bolivar MO 65613-3008 Ph: (417) 326-6061 |
| NPI Number | 1811622525 |
|---|---|
| Provider Enumeration Date | 07/18/2022 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811622525 | NPI | - | NPPES |
| 14888370 | Other | CAQH NUMBER | |
| 2009015933 | Other | MO | STATE LINCENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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