Organization
COLUMBIA IMPLANTS AND PERIODONTICS L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NABIL E BEAINI D.D.S. (OWNER)
(614) 282-9106
Entity
Organization
Contact information
Practice address
201 W BROADWAY STE 5A, COLUMBIA, MO 65203-3842
(573) 443-0593
Mailing address
201 W BROADWAY STE 5A, COLUMBIA, MO 65203-3842
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
2009035935
MO
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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