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Organization
DODGE CITY DENTAL CARE
Active
Organization
DODGE CITY DENTAL CARE
Active
Other names
Bruce M Johnston DDS PA & W Cody Walters DDS PA A Dental Partnership
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONI MYERS (OFFICE MANAGER)
(620) 225-2650
Entity
Organization
Contact information
Practice address
2300 N 14TH STREET, SUITE 202, DODGE CITY, KS 67801
(620) 225-2650
(620) 225-7722
Mailing address
2300 N 14TH STREET, SUITE 202, DODGE CITY, KS 67801
(620) 225-2650
(620) 225-7722
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60130
NULL
1223G0001X
General Practice Dentistry
Primary
60130
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116721
BCBS OF KS
KS
01
—
KS1417934
UNITED CONCORDIA
KS
Enumeration date
12/01/2006
Last updated
08/22/2020
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