# MIDWEST DENTAL KANSAS WICHITA WOODLAWN PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Midwest Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013252097
- **Authorized official:** DIANA L QUILLIN DDS (OWNER)
- **Authorized official phone:** (316) 686-6601

## Contact information

- **Practice address:** 401 N WOODLAWN ST, WICHITA, KS 67208-4335
- **Practice address phone:** (316) 686-6601
- **Practice address fax:** (316) 686-6602
- **Mailing address:** 401 N WOODLAWN ST, WICHITA, KS 67208-4335
- **Mailing address phone:** (316) 686-6601
- **Mailing address fax:** (316) 686-6602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 7071 | KS | Yes |

## Other

- **Enumeration date:** 12/03/2012
- **Last updated:** 12/03/2012