Organization
SPRINGFIELD CELEBRATE PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MELANSON DMD (OWNER)
(417) 289-0000
Entity
Organization
Contact information
Practice address
4214 S FARM ROAD 135, SPRINGFIELD, MO 65810-3716
(417) 289-0000
Mailing address
4214 S FARM ROAD 135, SPRINGFIELD, MO 65810-3716
(417) 289-0000
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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