Organization
POPLAR BLUFF CHILDREN'S DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REECA DAVES D.D.S. (PEDIATRIC DENTIST)
(573) 778-3042
Entity
Organization
Contact information
Practice address
2951 KANELL BLVD, POPLAR BLUFF, MO 63901-4008
(573) 778-3042
Mailing address
2951 KANELL BLVD, POPLAR BLUFF, MO 63901-4008
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2012019714
MO
Other
Enumeration date
06/27/2013
Last updated
06/27/2013
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