Organization
CHARLES L. KINCAID D.D.S. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES L. KINCAID DDS (OWNER)
(785) 843-4333
Entity
Organization
Contact information
Practice address
306 E 23RD ST, LAWRENCE, KS 66046-4801
(785) 843-4333
(785) 843-1218
Mailing address
306 E 23RD ST, LAWRENCE, KS 66046-4801
(785) 843-4333
(785) 843-1218
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100096960B
—
KS
05
—
100348570B
—
KS
Enumeration date
11/02/2006
Last updated
10/28/2014
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