# GABRIEL WURDEMAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chautauqua Hills Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487869046
- **Authorized official:** MRS. GERALDINE WILLIAMS (OFFICE MANAGER)
- **Authorized official phone:** (620) 725-3122

## Contact information

- **Practice address:** 120 W OSAGE ST, SEDAN, KS 67361-1518
- **Practice address phone:** (620) 725-3122
- **Practice address fax:** (620) 725-5395
- **Mailing address:** 120 W OSAGE ST, SEDAN, KS 67361-1518
- **Mailing address phone:** (620) 725-3122
- **Mailing address fax:** (620) 725-5395

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 60391 | KS | Yes |

## Other

- **Enumeration date:** 05/14/2007
- **Last updated:** 07/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200380810A | — | KS |