# TRI-COUNTY ORTHODONTICS, ASSOCIATES, LTD

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

## Provider details

- **NPI number:** 1649445321
- **Authorized official:** DR. JACQUELINE M. MILLER DDS, MS (ORTHODONTIST)
- **Authorized official phone:** (636) 239-4004

## Contact information

- **Practice address:** 1015 WASHINGTON SQUARE SHOPPING CTR STE G, WASHINGTON, MO 63090-5307
- **Practice address phone:** (636) 239-4004
- **Practice address fax:** (636) 239-6576
- **Mailing address:** 1015-G WASHINGTON SQUARE SHOPPING CENTER, WASHINGTON, MO 63090
- **Mailing address phone:** (636) 239-4004
- **Mailing address fax:** (636) 239-6576

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DE015380 | MO | Yes |

## Other

- **Enumeration date:** 04/24/2008
- **Last updated:** 04/24/2008