# DAVID J HART DDS LLC

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

## Provider details

- **NPI number:** 1629280755
- **Authorized official:** DR. DAVID JAMES HART DDS (MANAGER)
- **Authorized official phone:** (620) 792-5523

## Contact information

- **Practice address:** 1916 MAIN ST, GREAT BEND, KS 67530
- **Practice address phone:** (620) 792-7622
- **Mailing address:** 1916 MAIN ST, GREAT BEND, KS 67530
- **Mailing address phone:** (620) 792-7622

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 60403 | KS | Yes |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 10/23/2012