Copper Creek LLC

NPI #1104319862 in Ozark, Missouri

Provider Information

NPI Number
1104319862
Entity Type
Organization
Organization Name
Copper Creek LLC
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Jun 7, 2018
Last Updated
Jun 7, 2018

Practice Location

Address
797 W SOUTH ST
City
Ozark
ZIP Code
65721-9261
Phone
(417) 581-0835

Authorized Official

Name
DR. JONATHAN W JACOBY, DDS
Title
DENTIST
Phone
(816) 863-7096

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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