Leavenworth Oral & Maxillofacial Surgeons PA
NPI #1609841493 in Leavenworth, Kansas
Provider Information
- NPI Number
- 1609841493
- Entity Type
- Organization
- Organization Name
- Leavenworth Oral & Maxillofacial Surgeons PA
- Primary Specialty
- Dentist - Oral and Maxillofacial Pathology
- Enumeration Date
- Feb 23, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 3550 S 4TH ST
- Address 2
- SUITE 240
- City
- Leavenworth
- State
- Kansas
- ZIP Code
- 66048-5071
- Phone
- (913) 772-4334
Authorized Official
- Name
- DR. LARRY D EVANS, D.D.S.
- Title
- PRESIDENT
- Phone
- (913) 772-4334
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Pathology — Oral and Maxillofacial Pathology |
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