# ADS OSAGE BEACH LP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144095100
- **Authorized official:** KARI A HICKS (MANAGING DIRECTOR)
- **Authorized official phone:** (417) 501-1082

## Contact information

- **Practice address:** 4320 OSAGE BEACH PKWY, OSAGE BEACH, MO 65065-2199
- **Practice address phone:** (573) 348-1466
- **Mailing address:** PO BOX 2933, SPRINGFIELD, MO 65801-2933

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/20/2023
- **Last updated:** 11/20/2023