# CARRIAGE FAMILY DENTAL, PA

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

## Provider details

- **NPI number:** 1053995613
- **Authorized official:** LIZZIE YOUNG (CREDENTIALING MGR)
- **Authorized official phone:** (405) 233-8873

## Contact information

- **Practice address:** 726 SHAWNEE ST, LEAVENWORTH, KS 66048-1804
- **Practice address phone:** (913) 682-2595
- **Mailing address:** 726 SHAWNEE ST, LEAVENWORTH, KS 66048-1804
- **Mailing address phone:** (913) 682-2595

## Taxonomy

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

## Other

- **Enumeration date:** 05/10/2021
- **Last updated:** 02/14/2023