# OLATHE SOUTH DENTISTRY, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Olathe South Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245710193
- **Authorized official:** THERESA RAWALT DDS (OWNER)
- **Authorized official phone:** (913) 286-4548

## Contact information

- **Practice address:** 16587 W 151ST ST, OLATHE, KS 66062
- **Practice address phone:** (913) 286-4548
- **Mailing address:** PO BOX 920050, DALLAS, TX 75392-0050
- **Mailing address phone:** (714) 845-8500
- **Mailing address fax:** (303) 952-0892

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 08/20/2018
- **Last updated:** 05/11/2022