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General NPI Number Information
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NPI Number | 1235832510
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Entity Type | Organization
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Legal Business Name | NIXA DENTAL PARTNERS, LLC
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Dates
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Enumeration Date | 03/24/2023
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 729 W CENTER CIR STE 104
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City | NIXA
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State | MO
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Zip | 65714-7027
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Country | US
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Telephone | 417-595-4470
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Fax |
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Provider Business Mailing Address
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Address Line | 729 W CENTER CIR STE 104
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City | NIXA
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State | MO
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Zip | 65714-7027
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Country | US
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Telephone | 417-595-4470
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GABRIEL K HARR
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Credential | DDS
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Telephone | 785-342-8222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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