# ADS ROLLA LP

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

## Provider details

- **NPI number:** 1548035504
- **Authorized official:** KARI A HICKS (MANAGING DIRECTOR)
- **Authorized official phone:** (417) 501-1082

## Contact information

- **Practice address:** 416 S BISHOP AVE, ROLLA, MO 65401-4311
- **Practice address phone:** (573) 426-5447
- **Practice address fax:** (573) 426-5659
- **Mailing address:** PO BOX 2933, SPRINGFIELD, MO 65801-2933
- **Mailing address phone:** (417) 501-1082
- **Mailing address fax:** (417) 501-1728

## Taxonomy

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

## Other

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