Organization
CENTAL KANSAS DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURT ALLEN WILLIAMS DDS (OWNER)
(785) 472-3803
Entity
Organization
Contact information
Practice address
202 N DOUGLAS AVE, ELLSWORTH, KS 67439-3216
(785) 472-3803
(785) 472-3620
Mailing address
202 N DOUGLAS AVE, ELLSWORTH, KS 67439-3216
(785) 472-3803
(785) 472-3620
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6652
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19253
BLUE CROSS BLUE SHIELD
KS
Enumeration date
05/05/2006
Last updated
09/09/2008
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