Organization
CAROL M. YSIDRO, D.D.S.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MONTE YSIDRO (BUSINESS MANAGER)
(316) 788-2118
Entity
Organization
Contact information
Practice address
900 E. MEADOWLARK, DERBY, KS 67037-5258
(316) 788-2118
(316) 789-9098
Mailing address
PO BOX 1258, 900 E. MEADOWLARK, DERBY, KS 67037-5258
(316) 788-2118
(316) 789-9098
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
60024
KS
Other
Enumeration date
12/11/2006
Last updated
08/22/2020
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