# GHANTA DENTISTRY PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maple Park Dental Centre
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235898214
- **Authorized official:** DR. RANJIT GHANTA DMD (OWNER DENTIST)
- **Authorized official phone:** (432) 934-1548

## Contact information

- **Practice address:** 415 S 119TH ST W, WICHITA, KS 67235-1816
- **Practice address phone:** (316) 941-5997
- **Mailing address:** 415 S 119TH ST W, WICHITA, KS 67235-1816
- **Mailing address phone:** (316) 941-5997

## Taxonomy

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

## Other

- **Enumeration date:** 12/16/2021
- **Last updated:** 12/16/2021