Organization
SOUTHEAST MISSOURI HEALTH NETWORK
Active
Other names
BERNIE DENTAL Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SARA DEANE (CHIEF FINANCIAL OFFICER)
(573) 313-2500
Entity
Organization
Contact information
Practice address
741 S WALNUT ST, BERNIE, MO 63822-8900
(573) 293-6930
(573) 293-6841
Mailing address
741 SOUTH WALNUT, BERNIE, MO 63822
(573) 293-6930
(573) 293-6841
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598069247
—
MO
Enumeration date
01/10/2011
Last updated
03/22/2021
Update your record
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