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NPI Code Detail

MEDICARE: CEDRIC PAPA D.D.S.

MEDICARE: CEDRIC PAPA D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry2012021220MO

General Provider Information

NPI Number : 1407110992
Entity Type Code : Individual
Provider Name (Legal Business Name) : CEDRIC PAPA D.D.S.
Provider Business Mailing Address
First Line : 106 S MAIN ST
Second Line :
City : VANDALIA
State : MO
Zip : 63382-1806
Country : US
Telephone Number : 573-594-6166
Fax Number :
Provider Business Practice Location Address
First Line : 2211 HOLLOW RIDGE CT
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-9854
Country : US
Telephone Number : 415-413-7272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2012
Last Update Date : 02/04/2016

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Directions to “ CEDRIC PAPA D.D.S.” Practice Location

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