Organization
PRAIRIE DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEE JO HOLMAN DDS (DENTIST OWNER SEC-TREASURER)
(620) 792-1941
Entity
Organization
Contact information
Practice address
1701 WILLIAMS, GREAT BEND, KS 67530-2542
(620) 792-1941
(620) 792-2766
Mailing address
1701 WILLIAMS, GREAT BEND, KS 67530-2542
(620) 792-1941
(620) 792-2766
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5951
KS
Other
Enumeration date
08/09/2006
Last updated
08/22/2020
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