Organization
KENNETH W. NELSON, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH W NELSON DDS (OWNER)
(316) 634-1414
Entity
Organization
Contact information
Practice address
1919 N. WEBB RD, WICHITA, KS 67206-3405
(316) 634-1414
(316) 634-2907
Mailing address
1919 N WEBB RD, WICHITA, KS 67206-3405
(316) 634-1414
(316) 634-2907
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5149
KS
Other
Enumeration date
07/21/2010
Last updated
07/21/2010
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