Organization
MATCHSTICK LLC
Active
Other names
DaVinci Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY VIRGINIA GADBOIS DDS (CHIEF FINANCIAL OFFICER)
(573) 446-0880
Entity
Organization
Contact information
Practice address
2401 BERNADETTE DR, SUITE 217, COLUMBIA, MO 65203-4672
(573) 445-1100
(573) 445-1153
Mailing address
3600 VAWTER SCHOOL RD, COLUMBIA, MO 65203-9418
(573) 445-1100
(573) 445-1153
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2009013643
MO
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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