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Organization

DR. KENNETH COLBERT DDS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH COLBERT (PRESIDENT)
(573) 775-2636
Entity
Organization

Contact information

Practice address
PO BOX AQ, 204 W MAIN ST, STEELVILLE, MO 65565-0609
(573) 775-2636
Mailing address
PO BOX AQ, 204 W. MAIN ST, STEELVILLE, MO 65565-0609
(573) 775-2636

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
013305
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4012188050
MO
Enumeration date
04/17/2017
Last updated
04/17/2017
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