Organization
TW PRACTICE PARTNERS MISSOURI PC
Active
Other names
ROLLA FAMILY DENTISTRY
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN MCCOSTLIN (CEO)
(615) 479-2196
Entity
Organization
Contact information
Practice address
1701 E 10TH ST, ROLLA, MO 65401-4601
(573) 364-1599
Mailing address
10 BURTON HILLS BLVD STE 400, NASHVILLE, TN 37215-3004
(615) 479-2196
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
11/02/2023
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