Organization
WAKASHAW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP CHARLES GAUS DDS (OWNER/MANAGER)
(785) 856-6010
Entity
Organization
Contact information
Practice address
4901 LEGENDS DR, LAWRENCE, KS 66049-5800
(785) 856-6010
(785) 841-6480
Mailing address
4901 LEGENDS DR, LAWRENCE, KS 66049-5800
(785) 856-6010
(785) 841-6480
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
60952
KS
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
6706
KS
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
KS
Other
Enumeration date
05/08/2014
Last updated
07/17/2014
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