# MOUNDRIDGE DENTAL CENTER CHARTERED

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1538469671
- **Authorized official:** JAY WARREN HILDRETH JR. DDS (OWNER)
- **Authorized official phone:** (785) 456-7083

## Contact information

- **Practice address:** 324 E 2ND ST, MOUNDRIDGE, KS 67107-7164
- **Practice address phone:** (620) 345-2100
- **Practice address fax:** (620) 345-2106
- **Mailing address:** 5566 MAEFIELD DR STE B, WAMEGO, KS 66547-9109
- **Mailing address phone:** (785) 456-7083
- **Mailing address fax:** (785) 456-6520

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 60728 | KS | Yes |

## Other

- **Enumeration date:** 10/22/2010
- **Last updated:** 10/22/2012