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Organization
DR. JOE WOMMACK, P.A.
Active
Organization
DR. JOE WOMMACK, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOE B WOMMACK (OWNER DENTIST)
(620) 421-0980
Entity
Organization
Contact information
Practice address
1701 WASHINGTON AVE, PARSONS, KS 67357-3204
(620) 421-0980
Mailing address
1701 WASHINGTON AVE, PARSONS, KS 67357-3204
(620) 421-0980
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5853
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5853
KS DENTAL LICENSE
KS
01
—
8345
BCBS PROVIDER NUMBER
KS
Enumeration date
04/16/2007
Last updated
08/22/2020
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