# PRAIRIE ROCK DENTAL, P.A.

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

## Provider details

- **NPI number:** 1710588900
- **Authorized official:** SCOTT GUEST (COO)
- **Authorized official phone:** (913) 645-0079

## Contact information

- **Practice address:** 8123 E HARRY ST, WICHITA, KS 67207-4603
- **Practice address phone:** (316) 686-3397
- **Mailing address:** 1915 S OHIO CT STE 259, SALINA, KS 67401-6602
- **Mailing address phone:** (785) 404-2070

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 11/04/2020
- **Last updated:** 02/01/2023