Organization
ACCESS DENTAL & DENTURES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARI HICKS (DIRECTOR OF ADMINISTRATION)
(417) 501-1082
Entity
Organization
Contact information
Practice address
1402 S ELLIOTT AVE, AURORA, MO 65605-2104
(417) 501-1082
(417) 501-1661
Mailing address
1701 W SUNSHINE ST STE Q, SPRINGFIELD, MO 65807-2261
(417) 501-1048
(417) 501-1661
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114279460
NPPES
MO
05
—
1215241005
—
MO
01
—
1275048324
NPPES
MO
01
—
1376088369
NPPES
MO
05
—
1427356989
—
MO
01
—
1649589706
NPPES
MO
05
—
182138649
—
MO
Enumeration date
04/12/2018
Last updated
04/12/2018
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