| Robert Carroll, Dds, Pc | |
|
2935 Bagnell Dam Blvd Ste. 102 Lake Ozark MO 65049-8661 | |
| (573) 365-6600 | |
| (573) 365-6470 |
| Full Name | Robert Carroll, Dds, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2935 Bagnell Dam Blvd, Lake Ozark, Missouri |
| Authorized Official Name and Position | Robert E Carroll (OWNER) |
| Authorized Official Contact | 5733656600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Carroll, Dds, Pc Po Box 827 Lake Ozark MO 65049-0827 Ph: (573) 365-6600 | Robert Carroll, Dds, Pc 2935 Bagnell Dam Blvd Ste. 102 Lake Ozark MO 65049-8661 Ph: (573) 365-6600 |
| NPI Number | 1629271564 |
|---|---|
| Provider Enumeration Date | 06/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629271564 | NPI | - | NPPES |
| 1073532800 | Other | MO | TYPE 1 NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 13964 (Missouri) | Primary |
Premier Dental And Oral Health Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 N Shore Dr, Lake Ozark, MO 65049 Phone: 573-365-0220 Fax: 573-365-1962 |