Individual
KYLE DETMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
404 S EDGEMOOR ST STE 320, WICHITA, KS 67218-1632
(316) 559-3993
Mailing address
8930 W SUNCREST ST APT 603, WICHITA, KS 67212-4069
(316) 617-7184
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
61906
KS
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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