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Individual

DR. STEPHEN KIRK VINCENT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
4811 BOB BILLINGS PKWY, SUITE A, LAWRENCE, KS 66049-3851
(785) 841-2902
(785) 841-5312
Mailing address
4811 BOB BILLINGS PKWY, SUITE A, LAWRENCE, KS 66049-3851
(785) 841-2902
(785) 841-5312

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6362
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
116521
PTAN
KS
Enumeration date
09/11/2006
Last updated
08/04/2009
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