Organization
J. WARREN HILDRETH, JR DDS PC OF MISSOURI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN GEORGE (CEO)
(417) 466-7196
Entity
Organization
Contact information
Practice address
558 E MOUNT VERNON BLVD, MOUNT VERNON, MO 65712-2102
(417) 466-7196
(417) 466-2129
Mailing address
558 E MOUNT VERNON BLVD, MOUNT VERNON, MO 65712-2102
(417) 466-7196
(417) 466-2129
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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