Organization
MY DENTIST WICHITA, PA
Active
Parent organization
MY DENTIST WICHITA, PA
Other names
Wheatland Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
MY DENTIST WICHITA, PA
Authorized official
KENDRA WALKER (CREDENTIALING COORDINATOR)
(217) 540-8312
Entity
Organization
Contact information
Practice address
1443 N ROCK RD, WICHITA, KS 67206-1245
(316) 295-2830
Mailing address
1443 N ROCK RD, WICHITA, KS 67206-1245
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/18/2014
Last updated
10/27/2015
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