# SURGERY CENTER OF DODGE CITY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013915685
- **Authorized official:** MRS. DINA LANE BSN (ADMINISTRATOR)
- **Authorized official phone:** (620) 408-9454

## Contact information

- **Practice address:** 2203 SUMMERLON CIR, DODGE CITY, KS 67801-2985
- **Practice address phone:** (620) 408-9454
- **Practice address fax:** (620) 408-9552
- **Mailing address:** 2203 SUMMERLON CIR, DODGE CITY, KS 67801-2985
- **Mailing address phone:** (620) 408-9454
- **Mailing address fax:** (620) 408-9552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | S029001 | KS | Yes |

## Other

- **Enumeration date:** 07/08/2005
- **Last updated:** 08/22/2020