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Organization

BPD SOUTH LLC

Active
Other names
Ben Pyatt Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BEN T PYATT DDS (DENTIST/OWNER)
(417) 732-2823
Entity
Organization

Contact information

Practice address
3776 N MEADOWGATE CT, SPRINGFIELD, MO 65803-7990
(417) 833-8253
Mailing address
258 US HIGHWAY 60 E, REPUBLIC, MO 65738-1938
(417) 732-7090
(417) 732-4442

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
2009013241
MO
122300000X
Dentist
Primary
2009015903
MO

Other

Enumeration date
07/14/2015
Last updated
07/14/2015
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