Organization
JEFFRY P. GARDNER, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFRY PAUL GARDNER D.D.S. (OWNER)
(660) 582-4655
Entity
Organization
Contact information
Practice address
109 S BUCHANAN ST, MARYVILLE, MO 64468-2384
(660) 582-4655
Mailing address
109 S BUCHANAN ST, MARYVILLE, MO 64468-2384
(660) 582-4655
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2000150769
MO
Other
Enumeration date
06/13/2007
Last updated
08/22/2020
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