Provider Demographics
NPI:1609288653
Name:DOVE DENTAL GROUP, LLC
Entity Type:Organization
Organization Name:DOVE DENTAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:DOVE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:417-866-7647
Mailing Address - Street 1:2910 E BATTLEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-4016
Mailing Address - Country:US
Mailing Address - Phone:417-866-7647
Mailing Address - Fax:417-866-7309
Practice Address - Street 1:2910 E BATTLEFIELD ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4016
Practice Address - Country:US
Practice Address - Phone:417-866-7647
Practice Address - Fax:417-866-7309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012015527122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty