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Individual

DR. MICHAEL SEAN TODD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1500 VANDIVER, SUITE 104, COLUMBIA, MO 65202
(573) 814-1694
(573) 814-2845
Mailing address
1500 VANDIVER, SUITE 104, COLUMBIA, MO 65202
(573) 814-1694
(573) 814-2845

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
015815
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
431734574
COMPANY TAX ID
MO
Enumeration date
06/01/2005
Last updated
09/30/2008
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