Provider Demographics
NPI:1033765045
Name:OZARKS RESOURCE GROUP
Entity Type:Organization
Organization Name:OZARKS RESOURCE GROUP
Other - Org Name:OCHC-DADE COUNTY DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:CROUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-745-2121
Mailing Address - Street 1:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:MO
Mailing Address - Zip Code:65668
Mailing Address - Country:US
Mailing Address - Phone:833-789-5933
Mailing Address - Fax:417-745-0056
Practice Address - Street 1:3 N STATE HWY 39
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MO
Practice Address - Zip Code:65661-1391
Practice Address - Country:US
Practice Address - Phone:417-637-2345
Practice Address - Fax:417-328-1176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty