Southeast Missouri Health Network
Organization Active NPI Dentist · East Prairie, MO
NPI 1679019491 · NPPES record last updated Nov 9, 2017
Key facts
- NPI
- 1679019491
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- Legal business name
- SOUTHEAST MISSOURI HEALTH NETWORK
- Practice address
- 111 Prairie Drive
East Prairie, MO 63845 - Phone
- (573) 649-9311
- Fax
- (573) 649-9331
- NPI assigned
- Jan 18, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTHEAST MISSOURI HEALTH NETWORK
Authorized official
- Name
- Sara Deane
- Title
- Cfo
- Phone
- (573) 313-2500
Corporate family (same tax ID) 13
Practitioners 2
-
Sarah E Simptkins, RDH
-
Gabrielle A Roberts, DMD
National Provider Directory
- Tax ID family
- Southeast Missouri Network
- Part of
- Southeast Missouri Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | Yes |
Addresses
Primary practice location
111 Prairie Drive
East Prairie, MO 63845
Mailing address
111 Prairie Drive
East Prairie, MO 63845
Phone (573) 649-9311
Other practice location 1
111 Prairie Dr
Ste a & B
East Prairie, MO 63845-1114
Phone (573) 649-9311
Other providers in East Prairie, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.