Individual
DR. JEFFRY PAUL GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
109 S BUCHANAN ST, MARYVILLE, MO 64468-2384
(660) 582-4655
(660) 582-4682
Mailing address
109 S BUCHANAN ST, MARYVILLE, MO 64468-2384
(660) 582-4655
(660) 582-4682
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2000150769
MO
Other
Enumeration date
07/14/2005
Last updated
07/08/2007
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