Individual
KENNETH E BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 S MAIN ST, ULYSSES, KS 67880-2519
(620) 424-4499
Mailing address
113 S MAIN ST, ULYSSES, KS 67880-2519
(620) 424-4499
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5513
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100224750C
—
KS
01
—
1055673
DORAL
KS
Enumeration date
02/26/2006
Last updated
03/13/2009
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