Individual
KATHERINE BOXDORFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
22 S WEST ST, PERRYVILLE, MO 63775-2547
(573) 547-6691
Mailing address
93 RICHARDET ST, PERRYVILLE, MO 63775-2245
(573) 513-1265
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2022018729
MO
390200000X
Student in an Organized Health Care Education/Training Program
2022018729
MO
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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