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Organization
WICHITA FAMILY DENTAL SOUTH LLC
Active
Organization
WICHITA FAMILY DENTAL SOUTH LLC
Active
Other names
Derby Dental Care, Wichita Family Dental South
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE N BRANDES RDH (CLINICAL DIRECTOR)
(316) 630-9339
Entity
Organization
Contact information
Practice address
1120 N ROCK RD STE 100, DERBY, KS 67037-3587
(316) 630-9339
Mailing address
9339 E 21ST ST N, WICHITA, KS 67206-2971
(316) 630-9339
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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