# WICHITA FAMILY DENTAL PARTNERSHIP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wichita Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346597069
- **Authorized official:** CHARLES H PIERSON D.D.S. (DENTIST)
- **Authorized official phone:** (316) 630-9339

## Contact information

- **Practice address:** 9339 E 21ST ST N, SUITE 200, WICHITA, KS 67206-2971
- **Practice address phone:** (316) 630-9339
- **Practice address fax:** (316) 630-9353
- **Mailing address:** 9339 E 21ST ST N, SUITE 200, WICHITA, KS 67206-2971
- **Mailing address phone:** (316) 630-9339
- **Mailing address fax:** (316) 630-9353

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5979 | KS | Yes |

## Other

- **Enumeration date:** 08/13/2012
- **Last updated:** 08/13/2012