Buffalo Prairie Dental

NPI #1912276809 in Buffalo, Missouri

Provider Information

NPI Number: 1912276809
Entity Type: Organization
Organization Name: Buffalo Prairie Dental
Primary Specialty: Dentist
Enumeration Date: Dec 21, 2011
Last Updated: Dec 21, 2011

Practice Location

Address: 1006 S. ASH
City: Buffalo
State: Missouri
ZIP Code: 65622-0707
Phone: (417) 345-2793

Authorized Official

Name: CAROL JEAN THROCKMORTON
Title: OFFICE MANAGER
Phone: (417) 345-2793

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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