Organization
ACCENT DENTAL CENTER ON FORUM, LLC
Active
Organization
ACCENT DENTAL CENTER ON FORUM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEATHER R. BURTON (OFFICE MANAGER)
(573) 446-7181
Entity
Organization
Contact information
Practice address
1401 FORUM BLVD, STE. 203, COLUMBIA, MO 65203-1915
(573) 446-7181
(573) 446-1770
Mailing address
1401 FORUM BLVD, STE. 203, COLUMBIA, MO 65203-1915
(573) 446-7181
(573) 446-1770
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2003011293
MO
1223P0221X
Pediatric Dentistry
010435
MO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
1223X2210X
Orofacial Pain Dentistry
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
01/04/2007
Last updated
09/16/2021
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