Midwest Dental Kansas Derby PA

NPI #1417222993 in Derby, Kansas

Provider Information

NPI Number: 1417222993
Entity Type: Organization
Organization Name: Midwest Dental Kansas Derby PA
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 15, 2012
Last Updated: Mar 15, 2012

Practice Location

Address: 1700 E JAMES ST
City: Derby
State: Kansas
ZIP Code: 67037-3543
Phone: (316) 788-3736

Authorized Official

Name: ANDREW J NOLAN
Title: ATTORNEY
Phone: (316) 291-9542

Specialties & Taxonomy Codes

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

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