Organization
PROFESSIONAL ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MONICA TURNER TURNER (OFFICE ADMINISTRATOR)
(316) 729-5670
Entity
Organization
Contact information
Practice address
7570 W 21ST ST N STE 1042B, WICHITA, KS 67205-1763
(316) 729-5670
(316) 729-5496
Mailing address
7570 W 21ST ST N STE 1042B, WICHITA, KS 67205-1763
(316) 729-5670
(316) 729-5496
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
60147
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376527614
INDIVIDUAL NPI
KS
Enumeration date
09/13/2007
Last updated
09/13/2007
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