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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