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Organization
JON M. WOODRUFF, D.D.S.;P.A.
Active
Organization
JON M. WOODRUFF, D.D.S.;P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON MICHAEL WOODRUFF D.D.S. (OWNER/PRESIDENT)
(316) 684-7531
Entity
Organization
Contact information
Practice address
910 S HILLSIDE ST, WICHITA, KS 67211-4001
(316) 684-7531
(316) 684-1824
Mailing address
910 S HILLSIDE ST, WICHITA, KS 67211-4001
(316) 684-7531
(316) 684-1824
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6814
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017363
BCBS OF KS
KS
Enumeration date
05/22/2006
Last updated
08/22/2020
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