Organization
MAPLE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE J MAPLE DDS (DENTIST)
(620) 356-1221
Entity
Organization
Contact information
Practice address
307 N MAIN ST, ULYSSES, KS 67880-2132
(620) 356-1221
(620) 356-5204
Mailing address
307 N MAIN ST, ULYSSES, KS 67880-2132
(620) 356-1221
(620) 356-5204
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4614
KS
Other
Enumeration date
09/26/2013
Last updated
09/26/2013
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