Organization
JOPLIN ORAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW W SHEFFER DDS (OWNER)
(417) 624-2333
Entity
Organization
Contact information
Practice address
2700 MCCLELLAND BLVD, BLDG C SUITE 302, JOPLIN, MO 64804-1623
(417) 624-2333
(405) 848-0033
Mailing address
2700 MCCLELLAND BLVD, BLDG C SUITE 302, JOPLIN, MO 64804-1623
(417) 624-2333
(405) 848-0033
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2007032185
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007032185
ORAL SURGERY LICENSE
MO
Enumeration date
05/06/2008
Last updated
05/06/2008
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