# DOUGLAS COUNTY DENTAL CLINIC, INC

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

## Provider details

- **NPI number:** 1396734737
- **Authorized official:** MS. JULIE MEREDITH BRANSTROM (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (785) 312-7770

## Contact information

- **Practice address:** 2210 YALE RD, LAWRENCE, KS 66049-2647
- **Practice address phone:** (785) 312-7770
- **Practice address fax:** (785) 312-9447
- **Mailing address:** 2210 YALE RD, LAWRENCE, KS 66049-2647
- **Mailing address phone:** (785) 312-7770
- **Mailing address fax:** (785) 312-9447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | 60218 | KS | Yes |

## Other

- **Enumeration date:** 10/18/2005
- **Last updated:** 11/05/2014