SAMUEL E DEATHERAGE DMD PC

MOUNTAIN GROVE, MO
NPI1619040078
Entity TypeOrganization
Authorized ContactSAMUEL E DEATHERAGE
President
417-926-4910
Organization Subpart ?No
Primary Taxonomy1223G0001X Dentist, General Practice
Enumeration Date2006-11-15
Last Update Date2020-08-22
Business Address
SAMUEL E DEATHERAGE DMD PC
920 NORTH MAIN
MOUNTAIN GROVE, MO 65711-1315
Phone number: 417-926-4910
Mailing Address
SAMUEL E DEATHERAGE DMD PC
920 NORTH MAIN
MOUNTAIN GROVE, MO 65711-1315
Phone number: 417-926-4910
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