Organization
PREMIER DENTAL AND ORAL HEALTH GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD ERIC MASSIE DDS, FAGD (PRESIDENT)
(573) 365-0220
Entity
Organization
Contact information
Practice address
24 N SHORE DR, LAKE OZARK, MO 65049-7111
(573) 365-0220
(573) 365-1962
Mailing address
24 N SHORE DR, LAKE OZARK, MO 65049-7111
(573) 365-0220
(573) 365-1962
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
015226
MO
Other
Enumeration date
11/16/2005
Last updated
08/21/2007
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