Individual
STEPHEN VANCE MOORKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
912 N CEDAR ST, ROLLA, MO 65401-3350
(573) 364-1345
Mailing address
902 COUNTRY LN, ROLLA, MO 65401-4716
(573) 578-6623
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2017017371
MO
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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