Organization
HETMIR LLC
Active
Other names
Thayer Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMIR PRAKASH PATEL D.M.D (CEO)
(417) 264-7266
Entity
Organization
Contact information
Practice address
205 N 2ND ST, THAYER, MO 65791-1263
(417) 264-7266
(417) 264-7273
Mailing address
205 N 2ND ST, THAYER, MO 65791-1263
(417) 264-7266
(417) 264-7273
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2011010982
MO
Other
Enumeration date
10/24/2012
Last updated
10/24/2012
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