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NPI Code Detail

MEDICARE: MARY V GADBOIS DDS

MEDICARE:   MARY V GADBOIS  DDS
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
1122300000XDentist2000158124MO

General Provider Information

NPI Number : 1679783591
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY V GADBOIS DDS
Provider Business Mailing Address
First Line : 2012 CHERRY HILL DR
Second Line : SUITE 101
City : COLUMBIA
State : MO
Zip : 65203-5882
Country : US
Telephone Number : 573-446-0880
Fax Number : 573-447-3121
Provider Business Practice Location Address
First Line : 2012 CHERRY HILL DR
Second Line : SUITE 101
City : COLUMBIA
State : MO
Zip : 65203-5882
Country : US
Telephone Number : 573-446-0880
Fax Number : 573-447-3121
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 07/08/2007

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Directions to “ MARY V GADBOIS DDS” Practice Location

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