Organization
BRACES OF THE OZARKS, LLC
Active
Organization
BRACES OF THE OZARKS, LLC
Active
Other names
Branson Braces
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK DAKE (OWNER)
(501) 781-2777
Entity
Organization
Contact information
Practice address
168 S PAYNE STEWART DR, STE 100, BRANSON, MO 65616-2792
(417) 414-0011
Mailing address
PO BOX 24470, LITTLE ROCK, AR 72221-4470
(501) 781-2777
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043609522
—
AR
Enumeration date
05/05/2015
Last updated
05/05/2015
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