Individual
DR. CHARLES L KINCAID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
306 E 23RD ST, LAWRENCE, KS 66046-4801
(785) 843-4559
(785) 843-1218
Mailing address
PO BOX 3745, LAWRENCE, KS 66046-0745
(785) 843-4559
(785) 843-1218
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5272
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100096960A
—
KS
01
—
116696
BCBSKS
—
01
—
12985022
BCBSKC
—
01
—
21647
UNITED CONCORDIA
—
Enumeration date
03/09/2006
Last updated
10/06/2017
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