First Avenue Dental, P.a.

NPI #1275199168 in Liberal, Kansas

Provider Information

NPI Number: 1275199168
Entity Type: Organization
Organization Name: First Avenue Dental, P.a.
Subpart: Yes (part of a larger organization)
Parent Organization: FIRST AVENUE DENTAL, P.A.
Primary Specialty: Dentist - General Practice
Enumeration Date: May 15, 2019
Last Updated: Aug 19, 2021

Practice Location

Address: 23 E 11TH ST
City: Liberal
State: Kansas
ZIP Code: 67901-2720
Phone: (620) 604-9279

Authorized Official

Name: RYAN LEHMKUHLER, DDS
Title: PRESIDENT
Phone: (620) 371-6630

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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