Heartland Dental Group

NPI #1245317650 in Leavenworth, Kansas

Provider Information

NPI Number: 1245317650
Entity Type: Organization
Organization Name: Heartland Dental Group
Primary Specialty: Dentist
Enumeration Date: Nov 1, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 3507 S 4TH ST
City: Leavenworth
State: Kansas
ZIP Code: 66048-5013
Phone: (913) 682-1000

Authorized Official

Name: MARK ERNZEN
Title: ADMINISTRATOR
Phone: (913) 682-1000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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