CITIZENS MEMORIAL HEALTH CARE FOUNDATION NPI 1639384597

NPI Information

NPI: 1639384597
Provider Name: CITIZENS MEMORIAL HEALTH CARE FOUNDATION

Doing Business As: MILES FOR SMILES

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1500 N. OAKLAND AVE
BOLIVAR, MO
ZIP 65613
Phone: (417) 328-6334
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CITIZENS MEMORIAL HEALTH CARE FOUNDATION is a dental clinic center in Bolivar, MO. CITIZENS MEMORIAL HEALTH CARE FOUNDATION NPI is 1639384597. The provider is registered as an organization entity type.
The provider Is Doing Business As Miles For Smiles.

The provider's business location address is:

1500 N. OAKLAND AVE
BOLIVAR, MO
ZIP 65613-099
Phone: (417) 328-6334
Fax: (417) 328-7727

The provider's authorized official is Donald J. Babb .
The authorized official title is Ceo and has the following contact phone number (417) 326-6501.

The enumeration date for this NPI number is 5/14/2007 and was last updated on 10/4/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	505162107	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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