| Brick City Dental Llc | |
|
3612 S Clark St Mexico MO 65265-4104 | |
| (573) 581-4352 | |
| Not Available |
| Full Name | Brick City Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3612 S Clark St, Mexico, Missouri |
| Authorized Official Name and Position | Christopher Kollath (OWNER DENTIST) |
| Authorized Official Contact | 9547904438 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brick City Dental Llc 3612 S Clark St Mexico MO 65265-4104 Ph: (573) 581-4352 | Brick City Dental Llc 3612 S Clark St Mexico MO 65265-4104 Ph: (573) 581-4352 |
| NPI Number | 1184389603 |
|---|---|
| Provider Enumeration Date | 11/01/2021 |
| Last Update Date | 11/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184389603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |