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Organization

RICHARD J. ACKERMAN, JR. D.D.S.,M.S.,P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD J. ACKERMAN JR. DDS,MS (PRESIDENT-ORTHODONTIST)
(620) 227-2234
Entity
Organization

Contact information

Practice address
705 1ST AVE, SUITE B, DODGE CITY, KS 67801-4437
(620) 227-2234
(620) 227-8284
Mailing address
705 1ST AVE, SUITE B, DODGE CITY, KS 67801-4437
(620) 227-2234
(620) 227-8284

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4382
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40-85861501
KS
01
59637
BLUE CROSS BLUE SHIELD
KS
Enumeration date
04/24/2008
Last updated
04/24/2008
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