Organization
KIDSPACE PEDIATRIC DENTISTRY,P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE S. LE (OFFICE MANAGER)
(316) 684-2100
Entity
Organization
Contact information
Practice address
430 N WOODLAWN ST STE 1, WICHITA, KS 67208-4334
(316) 684-2100
(316) 684-2101
Mailing address
430 N WOODLAWN ST STE 1, WICHITA, KS 67208-4334
(316) 684-2100
(316) 684-2101
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6522
KS
Other
Enumeration date
02/07/2007
Last updated
08/22/2020
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