Organization
ICT DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRENTON EBERSOLE (OWNER)
(316) 272-7876
Entity
Organization
Contact information
Practice address
3151 N ROCK RD, WICHITA, KS 67226-1312
(316) 272-7876
Mailing address
PO BOX 70887, CLEVELAND, OH 44190-0887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/17/2022
Last updated
06/20/2023
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