# WISDOM FAMILY DENTISTRY, P.A.

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

## Provider details

- **NPI number:** 1487670089
- **Authorized official:** ERIC J WISDOM DDS (OWNER)
- **Authorized official phone:** (785) 632-2400

## Contact information

- **Practice address:** 712 6TH ST, CLAY CENTER, KS 67432-2915
- **Practice address phone:** (785) 632-2400
- **Practice address fax:** (785) 632-5893
- **Mailing address:** 712 6TH ST, CLAY CENTER, KS 67432-2915
- **Mailing address phone:** (785) 632-2400
- **Mailing address fax:** (785) 632-5893

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5188A | KS | Yes |

## Other

- **Enumeration date:** 07/15/2006
- **Last updated:** 01/04/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100095990B | — | KS |