Organization
DAVID L. DETAR, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID LAWRENCE DETAR DDS (OWNER)
(417) 781-8240
Entity
Organization
Contact information
Practice address
3115 ARIZONA AVE, JOPLIN, MO 64804-3125
(417) 781-8240
Mailing address
3115 ARIZONA AVE, JOPLIN, MO 64804-3125
(417) 781-8240
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
12028
MO
Other
Enumeration date
06/26/2007
Last updated
08/22/2020
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