Organization
STEPHEN M CARRON DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN M CARRON DDS (OWNER)
(573) 547-5570
Entity
Organization
Contact information
Practice address
12 S JACKSON ST STE 3, PERRYVILLE, MO 63775-2535
(573) 547-5570
Mailing address
12 S JACKSON ST STE 3, PERRYVILLE, MO 63775-2535
(573) 547-5570
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
013945
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401884408
—
MO
Enumeration date
09/30/2010
Last updated
09/30/2010
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