Organization
DENTAL PROFESSIONALS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONTE YSIDRO (BUSINESS MANAGER)
(316) 788-2118
Entity
Organization
Contact information
Practice address
900 E MEADOWLARK BLVD, DERBY, KS 67037-3465
(316) 788-2118
(316) 789-9098
Mailing address
900 E MEADOWLARK BLVD, DERBY, KS 67037-3465
(316) 788-2118
(316) 789-9098
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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