Organization
JEFFERSON CITY ORAL AND MAXILLOFACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA KAY BAKER (OFFICE MANAGER)
(573) 635-7216
Entity
Organization
Contact information
Practice address
1400 SOUTHWEST BLVD, SUITE C, JEFFERSON CITY, MO 65109-2490
(573) 635-7216
(573) 635-2646
Mailing address
1400 SOUTHWEST BLVD, SUITE C, JEFFERSON CITY, MO 65109-2490
(573) 635-7216
(573) 635-2646
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/24/2006
Last updated
01/31/2008
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