Organization
FIRST AVENUE DENTAL, P.A.
Active
Parent organization
FIRST AVENUE DENTAL, P.A.
Other names
First Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIRST AVENUE DENTAL, P.A.
Authorized official
RYAN LEHMKUHLER DDS (PRESIDENT)
(620) 371-6630
Entity
Organization
Contact information
Practice address
23 E 11TH ST, LIBERAL, KS 67901-2720
(620) 604-9279
(620) 417-9616
Mailing address
23 E 11TH ST, LIBERAL, KS 67901-2720
(620) 604-9279
(620) 417-9616
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/15/2019
Last updated
08/19/2021
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