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Organization
VOLLERTSEN FAMILY DENTISTRY
Active
Organization
VOLLERTSEN FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANT KURTIS VOLLERTSEN D.D.S. (DOCTOR OF DENTAL SURGERY)
(620) 275-4251
Entity
Organization
Contact information
Practice address
1402 1/2 KANSAS AVE., GARDEN CITY, KS 67846
(620) 275-4251
(620) 275-5389
Mailing address
1402 1/2 E KANSAS AVE, GARDEN CITY, KS 67846-5806
(620) 275-4251
(620) 275-5389
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
60401
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2003 857 90 B
—
KS
Enumeration date
11/03/2008
Last updated
11/03/2008
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