Organization
CARRIAGE FAMILY DENTAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZZIE YOUNG (CREDENTIALING MGR)
(405) 233-8873
Entity
Organization
Contact information
Practice address
726 SHAWNEE ST, LEAVENWORTH, KS 66048-1804
(913) 682-2595
Mailing address
726 SHAWNEE ST, LEAVENWORTH, KS 66048-1804
(913) 682-2595
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/10/2021
Last updated
02/14/2023
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