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Individual

DR. MICHELLE L DEARINGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
723 W MOUNT VERNON ST, NIXA, MO 65714-9663
(417) 725-3665
(417) 724-1987
Mailing address
708 W MOUNT VERNON ST, NIXA, MO 65714-9682
(417) 494-5017
(417) 494-5019

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016130
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1100329
STATE DRUG LICENSE
MO
Enumeration date
02/15/2006
Last updated
11/30/2015
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