Organization
FREDERICKTOWN FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ADAMS (OWNER)
(573) 783-4100
Entity
Organization
Contact information
Practice address
731 W MAIN ST, FREDERICKTOWN, MO 63645-1113
(573) 783-4100
Mailing address
731 W MAIN ST, FREDERICKTOWN, MO 63645-1113
(573) 783-4100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/15/2015
Last updated
09/16/2015
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