Organization
CROSS TRAILS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONA WELLS (CFO)
(573) 339-1196
Entity
Organization
Contact information
Practice address
307 GABRIEL ST, ADVANCE, MO 63730
(573) 722-3034
(573) 722-3244
Mailing address
307 GABRIEL ST, ADVANCE, MO 63730
(573) 332-0808
(573) 339-5803
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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