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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