| Professional Corporation | |
|
913 West Business Highway 60 Dexter MO 63841 | |
| (573) 624-7456 | |
| (573) 624-5182 |
| Full Name | Professional Corporation |
|---|---|
| Speciality | Dentist |
| Location | 913 West Business Highway 60, Dexter, Missouri |
| Authorized Official Name and Position | William T Kane (OWNER PRACTITIONER) |
| Authorized Official Contact | 5736247456 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Corporation Post Office Box 246 913 West Business Highway 60 Dexter MO 63841 Ph: (573) 624-7456 | Professional Corporation 913 West Business Highway 60 Dexter MO 63841 Ph: (573) 624-7456 |
| NPI Number | 1649302019 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649302019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 13323 (Missouri) | Primary |
Demaree Mitchell Family Dentistry Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 851 W Grant St, Dexter, MO 63841 Phone: 573-624-8005 |