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Individual

ADELA CASA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
204 N CEDAR ST, NEVADA, MO 64772-2310
(417) 549-6845
(417) 549-6836
Mailing address
PO BOX 1136, ANDERSON, MO 64831-1136
(417) 845-2246
(417) 845-2533

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2011014523
MO

Other

Enumeration date
09/06/2011
Last updated
09/06/2011
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