Organization
DENTRUST KANSAS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA A CLARK (DIRECTOR OF CREDENTIALING)
(267) 362-5938
Entity
Organization
Contact information
Practice address
300 KANSAS AVE BLDG 700, FORT LEAVENWORTH, KS 66027-1139
(267) 927-5000
Mailing address
6097 EASTON RD, PIPERSVILLE, PA 18947-1810
(267) 362-5938
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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