| Clear Creek Family Dental | |
|
609 E Wells St Ste F Ash Grove MO 65604-9087 | |
| (417) 751-9112 | |
| Not Available |
| Full Name | Clear Creek Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 609 E Wells St Ste F, Ash Grove, Missouri |
| Authorized Official Name and Position | Joshua Tanner Rust (PRESIDENT/OWNER) |
| Authorized Official Contact | 4177519112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Creek Family Dental 609 E Wells St Ste F Ash Grove MO 65604-9087 Ph: (417) 751-9112 | Clear Creek Family Dental 609 E Wells St Ste F Ash Grove MO 65604-9087 Ph: (417) 751-9112 |
| NPI Number | 1962725184 |
|---|---|
| Provider Enumeration Date | 03/02/2010 |
| Last Update Date | 03/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962725184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2009013248 (Missouri) | Primary |