Individual
DR. JESSE NATHANIEL GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1250 E WALNUT LAWN ST, SPRINGFIELD, MO 65804-4202
(417) 719-7862
(417) 719-7861
Mailing address
1250 E WALNUT LAWN ST, SPRINGFIELD, MO 65804-4202
(417) 719-7862
(417) 719-7861
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2012019137
MO
Other
Enumeration date
07/13/2012
Last updated
03/12/2015
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