# MIDWEST DENTAL KANSAS AUGUSTA STATE STREET PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Midwest Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669841821
- **Authorized official:** DR. PAUL MITSCH III (OWNER)
- **Authorized official phone:** (316) 775-2482

## Contact information

- **Practice address:** 401 STATE ST, AUGUSTA, KS 67010-1105
- **Practice address phone:** (316) 775-2482
- **Mailing address:** 401 STATE ST, AUGUSTA, KS 67010-1105
- **Mailing address phone:** (316) 775-2482

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 09/17/2015
- **Last updated:** 09/17/2015