Individual
DR. SUSAN L WHEELER MOLSTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
814 JEFFERSON ST, ELLIS, KS 67637-2215
(785) 726-3557
Mailing address
814 JEFFERSON ST, ELLIS, KS 67637-2215
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6515
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100223820-A
DORAL PROVIDER NUMBER
KS
05
—
4054858601
—
KS
Enumeration date
12/15/2005
Last updated
01/10/2013
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