Provider Demographics
NPI:1679464549
Name:SPRINGFIELD DENTAL PARTNERS LLC
Entity type:Organization
Organization Name:SPRINGFIELD DENTAL PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:HARR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:417-544-1570
Mailing Address - Street 1:1722 S GLENSTONE AVE STE EE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-1516
Mailing Address - Country:US
Mailing Address - Phone:417-887-4435
Mailing Address - Fax:
Practice Address - Street 1:1722 S GLENSTONE AVE STE EE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1516
Practice Address - Country:US
Practice Address - Phone:417-887-4435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPRINGFIELD DENTAL PARTNERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty