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Organization

MIDWEST DENTAL KANSAS WICHITA WOODLAWN PA

Active
Other names
Midwest Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DIANA L QUILLIN DDS (OWNER)
(316) 686-6601
Entity
Organization

Contact information

Practice address
401 N WOODLAWN ST, WICHITA, KS 67208-4335
(316) 686-6601
(316) 686-6602
Mailing address
401 N WOODLAWN ST, WICHITA, KS 67208-4335
(316) 686-6601
(316) 686-6602

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7071
KS

Other

Enumeration date
12/03/2012
Last updated
12/03/2012
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