Organization
PERRY ENDODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAYNE PERRY D.D.S. (OWNER)
(801) 712-3631
Entity
Organization
Contact information
Practice address
215 S HILLSIDE ST, WICHITA, KS 67211-2128
(316) 681-3479
Mailing address
215 S HILLSIDE ST, WICHITA, KS 67211-2128
(316) 681-3479
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
61060
KS
Other
Enumeration date
10/29/2013
Last updated
10/29/2013
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