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General NPI Number Information
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NPI Number | 1215241005
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Entity Type | Organization
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Legal Business Name | ACCESS DENTAL SERVICES LP
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 1070 S BISHOP AVE UNIT B
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City | ROLLA
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State | MO
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Zip | 65401
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Country | US
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Telephone | 573-426-5447
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Fax | 573-426-5659
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Provider Business Mailing Address
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Address Line | PO BOX 2933
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City | SPRINGFIELD
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State | MO
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Zip | 65801-2933
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Country | US
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Telephone | 417-501-1082
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Fax | 417-501-7128
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MRS. KARI A HICKS
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Credential |
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Telephone | 417-501-1082
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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 | 2006012741
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License Number State | MO
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