Organization
MOUNDRIDGE DENTAL CENTER CHARTERED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY WARREN HILDRETH JR. DDS (OWNER)
(785) 456-7083
Entity
Organization
Contact information
Practice address
324 E 2ND ST, MOUNDRIDGE, KS 67107-7164
(620) 345-2100
(620) 345-2106
Mailing address
5566 MAEFIELD DR STE B, WAMEGO, KS 66547-9109
(785) 456-7083
(785) 456-6520
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60728
KS
Other
Enumeration date
10/22/2010
Last updated
10/22/2012
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