Cross Trails Medical Center
Dentist, General Practice in Advance, MO. Organization (NPI-2).
NPI number1841508264
StatusActive
Last updated in NPPESSep 20, 2010
Details
- NPI
- 1841508264
- Entity type
- Organization (NPI-2)
- Legal business name
- Cross Trails Medical Center
- Organization subpart
- No
- Enumeration date
- Sep 20, 2010
- Last updated
- Sep 20, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
307 Gabriel StAdvance, MO 63730
Phone 573-722-3034 · Fax 573-722-3244
Mailing address
307 Gabriel StAdvance, MO 63730
Phone 573-332-0808 · Fax 573-339-5803
Authorized official
Mona Wells
Cfo
5733391196
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