Organization
JOHN D. GAGNON DDS PA
Active
Organization
JOHN D. GAGNON DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D GAGNON DDS (OWNER)
(316) 722-0800
Entity
Organization
Contact information
Practice address
3510 N RIDGE RD, SUITE 500, WICHITA, KS 67205-1224
(316) 722-0800
(316) 722-5822
Mailing address
3510 N RIDGE RD, SUITE 500, WICHITA, KS 67205-1224
(316) 722-0800
(316) 722-5822
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6850
KS
Other
Enumeration date
12/14/2006
Last updated
02/17/2010
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