Organization
WICHITA ENDODONTICS LLC
Active
Parent organization
WICHITA ENDODONTICS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WICHITA ENDODONTICS LLC
Authorized official
JILL CORNELISON (OFFICE MANAGER)
(316) 681-1099
Entity
Organization
Contact information
Practice address
7721 W 21ST ST, WICHITA, KS 67205
(316) 681-1099
(316) 613-2417
Mailing address
7721 W. 21ST STREET, WICHITA, KS 67205-1737
(316) 681-1099
(316) 613-2417
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/18/2021
Last updated
03/18/2021
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