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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