Innovative Dental

LBN: Innovative Dental
Innovative Dental is an health care organization with primary practice located at 3424 S Culpepper Ct , Springfield MO 65804-3755. The organization recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as the primary health care specialty. Innovative Dental can be contacted via phone (417) 889-4746, or through Olson, Grant B via phone (417) 889-4746.

Contact Information

Primary practice address
3424 S Culpepper Ct Springfield MO 65804-3755
Phone: (417) 889-4746
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Olson, Grant B Doctor of Dental Surgery (DDS)
Phone: (417) 889-4746

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X 2011016216 Missouri

Profile Details

NPI number 1043622368
LBN Legal business name Innovative Dental
DBA Doing business as
Authorized official Olson, Grant B Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date May 21st, 2014
Last updated May 21st, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043622368 NPPES
Other 3424 DENTAL OFFICE

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