Midwest Dental Kansas Augusta State Street PA

NPI #1669841821 in Augusta, Kansas

Provider Information

NPI Number: 1669841821
Entity Type: Organization
Organization Name: Midwest Dental Kansas Augusta State Street PA
Primary Specialty: Dentist
Enumeration Date: Sep 17, 2015
Last Updated: Sep 17, 2015

Practice Location

Address: 401 STATE ST
City: Augusta
State: Kansas
ZIP Code: 67010-1105
Phone: (316) 775-2482

Authorized Official

Name: DR. PAUL MITSCH III
Title: OWNER
Phone: (316) 775-2482

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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