Individual
OLIVIA DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6250
Mailing address
520 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6250
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D.007627-C1
AL
Other
Enumeration date
07/29/2026
Last updated
07/29/2026
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