Organization
EDWARDS & WILSON PERIODONTICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHLI E GILL (BILLING MANAGER)
(785) 843-4076
Entity
Organization
Contact information
Practice address
4830 QUAIL CREST PLACE, LAWRENCE, KS 66049-3838
(785) 843-4076
(785) 843-6127
Mailing address
4830 QUAIL CREST PLACE, LAWRENCE, KS 66049-3838
(785) 843-4076
(785) 843-6127
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
6357
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1672853562
NPI FOR DENTIST ADDED TO OUR PRACTICE
KS
01
—
61063
DENTIST LICENSE NUMBER
KS
Enumeration date
08/30/2006
Last updated
01/27/2015
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