State Fair Dental LLC
NPI #1326644600 in Sedalia, Missouri
Provider Information
- NPI Number
- 1326644600
- Entity Type
- Organization
- Organization Name
- State Fair Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Dec 10, 2020
- Last Updated
- Dec 10, 2020
Practice Location
Authorized Official
- Name
- FAITH GASKINS
- Title
- DIRECTOR OF CREDENTIALING
- Phone
- (630) 877-3520
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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