Provider Demographics
NPI:1851158356
Name:UB DENTAL, LLC
Entity Type:Organization
Organization Name:UB DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:UBERROTH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:573-410-2924
Mailing Address - Street 1:904 SE TEQUESTA LN
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-2755
Mailing Address - Country:US
Mailing Address - Phone:573-410-2924
Mailing Address - Fax:
Practice Address - Street 1:1730 S 7 HWY
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-3947
Practice Address - Country:US
Practice Address - Phone:816-228-8400
Practice Address - Fax:816-396-8529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental