Organization
NORTHSIDE DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEMMIE WILLIAMS (ACCOUNT MANAGER)
(417) 862-2468
Entity
Organization
Contact information
Practice address
2105 W KEARNEY ST, SUITE A, SPRINGFIELD, MO 65803-1652
(417) 862-2468
(417) 863-6775
Mailing address
2105 W KEARNEY ST, SUITE A, SPRINGFIELD, MO 65803-1652
(417) 862-2468
(417) 863-6775
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10691
MO
Other
Enumeration date
03/28/2007
Last updated
08/22/2020
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