Organization
MIDMO DENTAL, LLC
Active
Other names
Robert Davis, DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT M DAVIS DDS (OWNER)
(816) 522-3549
Entity
Organization
Contact information
Practice address
1804 W 5TH ST, SEDALIA, MO 65301-2420
(816) 522-3549
Mailing address
11911 E 62ND TER, KANSAS CITY, MO 64133-6976
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2006014398
MO
Other
Enumeration date
01/16/2008
Last updated
01/16/2008
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