Organization
QUAIL CREST IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRETCHEN EDWARDS RDH (OFFICE MANAGER)
(785) 856-0117
Entity
Organization
Contact information
Practice address
4830 QUAIL CREST PL STE B, LAWRENCE, KS 66049-3842
(785) 856-0117
(785) 856-5082
Mailing address
4830 QUAIL CREST PL STE B, LAWRENCE, KS 66049-3842
(785) 856-0117
(785) 856-5082
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
6944
KS
1223P0300X
Periodontics
60071
KS
1223P0300X
Periodontics
Primary
6357
KS
124Q00000X
Dental Hygienist
1885
KS
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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