Craig Jay Asselmeier, DMD

Individual provider Active NPI General Practice Dentistry · Perryville, MO

NPI 1487756540 · NPPES record last updated Aug 30, 2011

Key facts

NPI
1487756540
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DE015584 (MO)
Practice address
300 Perry Plaza
Suite D
Perryville, MO 63775
Phone
(573) 547-3949
Fax
(573) 517-0716
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DE015584MOMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE015584 MO Yes

Addresses

Primary practice location

300 Perry Plaza
Suite D
Perryville, MO 63775

Mailing address

300 Perry Plaza
Suite D
Perryville, MO 63775
Phone (573) 547-3949

Other identifiers

IdentifierTypeStateIssuer
406856708MedicaidMO

Other providers in Perryville, MO

All providers in Perryville, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.