Organization
MICHAEL J DOSTAL DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DOSTAL DDS (SOLE MEMBER)
(785) 550-2682
Entity
Organization
Contact information
Practice address
5408 ROBERTS ST, SHAWNEE, KS 66226-3937
(785) 550-2682
Mailing address
5408 ROBERTS ST, SHAWNEE, KS 66226-3937
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60656
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200698320A
—
KS
Enumeration date
04/08/2011
Last updated
04/08/2011
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