Countryside Dentistry

NPI #1457411928 in Frontenac, Kansas

Provider Information

NPI Number: 1457411928
Entity Type: Organization
Organization Name: Countryside Dentistry
Primary Specialty: Dentist
Enumeration Date: Dec 12, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1034 NORTH HIGHWAY 69
City: Frontenac
State: Kansas
ZIP Code: 66763
Phone: (620) 232-2273

Authorized Official

Name: MS. REXANNA JO KNAPP
Title: OFFICE MANAGER
Phone: (620) 232-2273

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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