# CENTAL KANSAS DENTISTRY, PA

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

## Provider details

- **NPI number:** 1285682773
- **Authorized official:** KURT ALLEN WILLIAMS DDS (OWNER)
- **Authorized official phone:** (785) 472-3803

## Contact information

- **Practice address:** 202 N DOUGLAS AVE, ELLSWORTH, KS 67439-3216
- **Practice address phone:** (785) 472-3803
- **Practice address fax:** (785) 472-3620
- **Mailing address:** 202 N DOUGLAS AVE, ELLSWORTH, KS 67439-3216
- **Mailing address phone:** (785) 472-3803
- **Mailing address fax:** (785) 472-3620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6652 | KS | Yes |

## Other

- **Enumeration date:** 05/05/2006
- **Last updated:** 09/09/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 19253 | BLUE CROSS BLUE SHIELD | KS |