Individual
DR. RENATA L PROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
801 N MAPLE ST, MCPHERSON, KS 67460
(620) 241-6512
Mailing address
801 N MAPLE ST, MCPHERSON, KS 67460
(620) 241-6512
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9879
CO
1223G0001X
General Practice Dentistry
30-022383
OH
1223G0001X
General Practice Dentistry
Primary
KS60689
KS
Other
Enumeration date
08/22/2006
Last updated
11/23/2022
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