Individual
DR. MELISSA BOEREMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
205 E DAKOTA ST, BUTLER, MO 64730-2113
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2010017989
MO
1223G0001X
General Practice Dentistry
61142
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405546102
—
MO
Enumeration date
03/29/2011
Last updated
10/20/2022
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