DR. Frederick Wayne Stark, DDS

NPI #1699901595 in Derby, Kansas

Provider Information

NPI Number: 1699901595
Entity Type: Individual
Name: DR. Frederick Wayne Stark, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Jun 5, 2009
Last Updated: Jan 3, 2019

Practice Location

Address: 1710 E MADISON AVE STE 600
City: Derby
State: Kansas
ZIP Code: 67037-2285
Phone: (316) 788-4000

Specialties & Taxonomy Codes

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

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