# KENNETH L WILLIAMS D.D.S. P.A.

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

## Provider details

- **NPI number:** 1033197090
- **Authorized official:** DR. KENNETH L WILLIAMS D.D.S. (PRESIDENT)
- **Authorized official phone:** (620) 431-3000

## Contact information

- **Practice address:** 2607 S SANTA FE AVE, CHANUTE, KS 66720-3206
- **Practice address phone:** (620) 431-3000
- **Practice address fax:** (620) 431-6122
- **Mailing address:** 2607 S SANTA FE AVE, CHANUTE, KS 66720-3206
- **Mailing address phone:** (620) 431-3000
- **Mailing address fax:** (620) 431-6122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6093 | KS | Yes |

## Other

- **Enumeration date:** 01/09/2006
- **Last updated:** 01/23/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100222900-A | — | KS |
| 01 | — | 8522 | BC/BS PROVIDER \# | KS |