# KNOB NOSTER FAMILY DENTAL

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

## Provider details

- **NPI number:** 1205554144
- **Authorized official:** STACIA WEDDLE (INSURANCE SPECIALIST)
- **Authorized official phone:** (816) 769-6119

## Contact information

- **Practice address:** 204 N ADAMS AVE, KNOB NOSTER, MO 65336-1304
- **Practice address phone:** (660) 563-5633
- **Mailing address:** 204 N ADAMS AVE, KNOB NOSTER, MO 65336-1304

## Taxonomy

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

## Other

- **Enumeration date:** 08/17/2022
- **Last updated:** 08/17/2022