Organization
FANNIN, KAELIN, ROPKA, SCOTT & SPONENBERG DDS PC
Active
Other names
Parkcrest Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL S. FANNIN DDS (VICE PRESIDENT)
(417) 887-1220
Entity
Organization
Contact information
Practice address
540 W LASALLE ST, SPRINGFIELD, MO 65807-4712
(417) 887-1220
(417) 887-0357
Mailing address
540 W LASALLE ST, SPRINGFIELD, MO 65807-4712
(417) 887-1220
(417) 887-0357
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/09/2006
Last updated
10/14/2009
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