Organization
SOUTHWIND ORAL AND FACIAL SURGERY LLC
Active
Organization
SOUTHWIND ORAL AND FACIAL SURGERY LLC
Active
Other names
Southwind Oral and Facial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED DYE (OWNER)
(620) 663-1141
Entity
Organization
Contact information
Practice address
2301 N. WALDRON, HUTCHINSON, KS 67502-1133
(620) 663-1141
(620) 663-1373
Mailing address
2301 N. WALDRON, HUTCHINSON, KS 67502-1133
(620) 663-1141
(620) 663-1373
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6423
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022955
BLUE CROSS & BLUE SHIELD
KS
Enumeration date
09/07/2006
Last updated
12/21/2020
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