Organization
DENTISTSWICHITA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC S FARMER DDS (DENTIST)
(316) 722-1110
Entity
Organization
Contact information
Practice address
7520 W VILLAGE CIR, WICHITA, KS 67205-9362
(316) 722-1110
Mailing address
7520 W VILLAGE CIR, WICHITA, KS 67205-9362
(316) 722-1110
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61448
DENTAL LICENSE
KS
01
—
6717
DENTAL LICENSE
KS
Enumeration date
12/07/2021
Last updated
12/07/2021
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