Organization
MIDWEST DENTAL KANSAS DERBY PA
Active
Other names
Midwest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW J NOLAN (ATTORNEY)
(316) 291-9542
Entity
Organization
Contact information
Practice address
1700 E JAMES ST, DERBY, KS 67037-3543
(316) 788-3736
(316) 788-4158
Mailing address
1700 E JAMES ST, DERBY, KS 67037-3543
(316) 788-3736
(316) 788-4158
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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