Individual
ANDREA BODWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
123 N TYLER RD STE 100, WICHITA, KS 67212-3726
(316) 640-9049
Mailing address
2926 N WILD ROSE CT, WICHITA, KS 67205-1638
(316) 640-9049
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
11111
KS
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
07/05/2024
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