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Individual

DR. ROBERT ETHERTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
3100 E JACKSON BLVD, JACKSON, MO 63755-2957
(573) 243-1520
Mailing address
3100 E JACKSON BLVD, JACKSON, MO 63755-2957
(573) 243-1520

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2002015492
MO

Other

Enumeration date
12/11/2006
Last updated
04/26/2012
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