| Poplar Bluff Children's Dentistry, Llc | |
|
2951 Kanell Blvd Poplar Bluff MO 63901-4008 | |
| (573) 778-3042 | |
| Not Available |
| Full Name | Poplar Bluff Children's Dentistry, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2951 Kanell Blvd, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Reeca Daves (PEDIATRIC DENTIST) |
| Authorized Official Contact | 5737783042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Poplar Bluff Children's Dentistry, Llc 2951 Kanell Blvd Poplar Bluff MO 63901-4008 Ph: () - | Poplar Bluff Children's Dentistry, Llc 2951 Kanell Blvd Poplar Bluff MO 63901-4008 Ph: (573) 778-3042 |
| NPI Number | 1255771952 |
|---|---|
| Provider Enumeration Date | 06/27/2013 |
| Last Update Date | 06/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255771952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 2012019714 (Missouri) | Primary |
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