Organization
CAPITAL DENTISTRY FOR CHILDREN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DALE COYLE DDS (OWNER/MEMBER)
(573) 874-1990
Entity
Organization
Contact information
Practice address
931 WILDWOOD DR STE 104, JEFFERSON CITY, MO 65109-5719
(573) 874-1990
Mailing address
1000 W. NIFONG BLVD., BLDG 6, SUITE 130, COLUMBIA, MO 65203
(573) 874-1990
(573) 874-1923
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
016056
MO
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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