Organization
WICHITA FAMILY DENTAL SOUTH LLC
Active
Other names
Derby Dental Care, Wichita Family Dental South
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE N BRANDES RDH (CLINICAL DIRECTOR)
(316) 630-9339
Entity
Organization
Contact information
Practice address
1120 N ROCK RD STE 100, DERBY, KS 67037-3587
(316) 630-9339
Mailing address
9339 E 21ST ST N, WICHITA, KS 67206-2971
(316) 630-9339
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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