Lake Dental Clinic LLC
Organization Active NPI General Practice Dentistry · Camdenton, MO
NPI 1720141849 · NPPES record last updated Apr 24, 2008
Key facts
- NPI
- 1720141849
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- LAKE DENTAL CLINIC LLC
- Practice address
- 1497 N State Highway 5
Camdenton, MO 65020 - Phone
- (573) 346-7278
- Fax
- (573) 346-2176
- NPI assigned
- Dec 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Vernon Dale McElwee, DDS
- Title
- Owner
- Phone
- (573) 346-7278
Practitioners 5
-
Evan K Connell, DDS
-
Matthew Evan Connell, D.D.S
-
Michael H Otradovec, DDS
-
Alan Craig Wallace, DDS
-
Vicki L Waring, DDS
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
1497 N State Highway 5
Camdenton, MO 65020
Mailing address
PO Box 820
Camdenton, MO 65020
Phone (573) 346-7278
Other providers in Camdenton, MO
- Brett D Koons
- Anton Kosov
- Terry S Krantz
- Lake Area Citizens' Advisory Board, Inc.
- Lake Area Industries, Inc.
- Lake of the Ozarks Developmental Center
- Lake of the Ozarks Laser Pain Center LLC
- Lake Professional Hearing Aid Center
- Lake Regional Health System
- Lake Regional Health System
All providers in Camdenton, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2008. 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.