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General NPI Number Information
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NPI Number | 1053404186
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Entity Type | Organization
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Legal Business Name | RISCHER DENTAL ASSOCIATES
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1000 W NIFONG BLVD BLDG 8 STE 120
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City | COLUMBIA
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State | MO
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Zip | 65203-5661
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Country | US
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Telephone | 573-874-8744
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 W NIFONG BLVD BLDG 8 STE 120
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City | COLUMBIA
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State | MO
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Zip | 65203-5661
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Country | US
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Telephone | 573-874-8744
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | DR. JON G RISCHER
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Credential | DDS
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Telephone | 573-874-8744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14820
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License Number State | MO
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