# DENTAL ASSOCIATES OF WEST WICHITA, PA

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

## Provider details

- **NPI number:** 1770693046
- **Authorized official:** MIKE JONES (BUSINESS MANAGER)
- **Authorized official phone:** (316) 972-5358

## Contact information

- **Practice address:** 444 N RIDGE RD, WICHITA, KS 67212-6574
- **Practice address phone:** (316) 942-5358
- **Practice address fax:** (316) 942-7277
- **Mailing address:** 444 N RIDGE RD, WICHITA, KS 67212-6574
- **Mailing address phone:** (316) 942-5358
- **Mailing address fax:** (316) 942-7277

## Taxonomy

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

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/22/2020