# CHARLES L. KINCAID D.D.S. P.A.

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

## Provider details

- **NPI number:** 1477632560
- **Authorized official:** CHARLES L. KINCAID DDS (OWNER)
- **Authorized official phone:** (785) 843-4333

## Contact information

- **Practice address:** 306 E 23RD ST, LAWRENCE, KS 66046-4801
- **Practice address phone:** (785) 843-4333
- **Practice address fax:** (785) 843-1218
- **Mailing address:** 306 E 23RD ST, LAWRENCE, KS 66046-4801
- **Mailing address phone:** (785) 843-4333
- **Mailing address fax:** (785) 843-1218

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 11/02/2006
- **Last updated:** 10/28/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100096960B | — | KS |
| 05 | — | 100348570B | — | KS |