Tri-County Orthodontics, Associates, Ltd
Clinic/Center, Dental in Washington, MO. Organization (NPI-2).
NPI number1649445321
StatusActive
Last updated in NPPESApr 24, 2008
Details
- NPI
- 1649445321
- Entity type
- Organization (NPI-2)
- Legal business name
- Tri-County Orthodontics, Associates, Ltd
- Organization subpart
- No
- Enumeration date
- Apr 24, 2008
- Last updated
- Apr 24, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | DE015380 | MO | Yes |
Practice location
1015 Washington Square Shopping Ctr Ste GWashington, MO 63090-5307
Phone 636-239-4004 · Fax 636-239-6576
Mailing address
1015-G Washington Square Shopping CenterWashington, MO 63090
Phone 636-239-4004 · Fax 636-239-6576
Authorized official
Jacqueline M. Miller
Orthodontist
6362394004
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