Individual
DOUGLAS W FAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS.,MD
Contact information
Practice address
20168 W 153RD ST, OLATHE, KS 66062-9131
(913) 839-9709
(913) 839-9471
Mailing address
20168 W 153RD ST, OLATHE, KS 66062-9131
(913) 839-9709
(913) 839-9471
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
13540
MO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6713
KS
Other
Enumeration date
01/17/2006
Last updated
03/25/2017
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