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Organization
DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.
Active
Organization
DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HEINLEIN (COO)
(417) 683-4831
Entity
Organization
Contact information
Practice address
504 WEST BROADWAY AVE., AVA, MO 65608-6560
(417) 683-5739
Mailing address
PO BOX 1359, AVA, MO 65608-1359
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
NULL
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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