Organization
JACKSON DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CODY BELL DDS (OWNER)
(573) 243-5200
Entity
Organization
Contact information
Practice address
3100 E JACKSON BLVD, JACKSON, MO 63755-2957
(573) 243-5200
(573) 243-7571
Mailing address
3100 E JACKSON BLVD, JACKSON, MO 63755-2957
(573) 243-5200
(573) 243-7571
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2011014478
MO
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
12/02/2013
Last updated
12/02/2013
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