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Organization

KIDS DENTIST OF LAWRENCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLI HENDERSON DDO (MEMBER)
(785) 691-5223
Entity
Organization

Contact information

Practice address
1425 WAKARUSA DR STE D, LAWRENCE, KS 66049-4287
(785) 691-5223
Mailing address
4601 W 6TH ST STE A, LAWRENCE, KS 66049-4129

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
07/19/2017
Last updated
07/19/2017
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