# CROSS TRAILS MEDICAL CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1821151622
- **Authorized official:** VICKI A SMITH (CEO)
- **Authorized official phone:** (573) 332-0808

## Contact information

- **Practice address:** 109 HWY 51 NORTH, MARBLE HILL, MO 63764
- **Practice address phone:** (573) 238-2725
- **Practice address fax:** (573) 238-3795
- **Mailing address:** PO BOX 349, MARBLE HILL, MO 63764-0349
- **Mailing address phone:** (573) 238-2725
- **Mailing address fax:** (573) 238-9795

## Taxonomy

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

## Other

- **Enumeration date:** 12/19/2006
- **Last updated:** 08/22/2020