1043622368 INNOVATIVE DENTAL

Preferred Provider Organization

Active

Basic Information

Organization Name
INNOVATIVE DENTAL
Enumeration Date
May 21, 2014
Last Update
May 21, 2014
Authorized Official
GRANT B OLSON DDS
PRESIDENT/OWNER
Phone: (417) 889-4746

Practice Location

Address
3424 S CULPEPPER CT
SPRINGFIELD, MO 658043755
Phone
(417) 889-4746

Mailing Address

Address
3424 S CULPEPPER CT
SPRINGFIELD, MO 658043755
Phone
(417) 889-4746

Specialties & Taxonomies

Specialty Code Classification License State Primary
Preferred Provider Organization
305R00000X Preferred Provider Organization 2011016216 MO Primary

Other Identifiers

Identifier Type State Issuer
3424 01 N/A DENTAL OFFICE

Frequently Asked Questions

What is INNOVATIVE DENTAL's NPI number?
INNOVATIVE DENTAL's NPI number is 1043622368.
Which doctor has NPI number 1043622368?
The doctor with NPI number 1043622368 is INNOVATIVE DENTAL.
What is INNOVATIVE DENTAL's practice address?
INNOVATIVE DENTAL's practice address is 3424 S CULPEPPER CT, SPRINGFIELD, MO, 658043755.
Which doctor practices at 3424 S CULPEPPER CT, SPRINGFIELD, MO, 658043755?
INNOVATIVE DENTAL practices at 3424 S CULPEPPER CT, SPRINGFIELD, MO, 658043755.
What is INNOVATIVE DENTAL's phone number?
INNOVATIVE DENTAL's phone number is (417) 889-4746.
Who is (417) 889-4746?
(417) 889-4746 is the phone number for INNOVATIVE DENTAL.
What is INNOVATIVE DENTAL's specialty?
INNOVATIVE DENTAL's specialty is Preferred Provider Organization.
What type of doctor is INNOVATIVE DENTAL?
INNOVATIVE DENTAL is a Preferred Provider Organization.
Is INNOVATIVE DENTAL a Preferred Provider Organization?
Yes, INNOVATIVE DENTAL is a Preferred Provider Organization.
Is INNOVATIVE DENTAL still practicing?
Yes, INNOVATIVE DENTAL is currently practicing.
Is INNOVATIVE DENTAL accepting new patients?
INNOVATIVE DENTAL may be accepting new patients. Please call their office at (417) 889-4746 to inquire about availability.
Is NPI 1043622368 still active?
Yes, NPI 1043622368 is currently active.
Where does INNOVATIVE DENTAL practice?
INNOVATIVE DENTAL practices in SPRINGFIELD, MO.