| |
301 E Main St Osawatomie KS 66064-1129 | |
(913) 755-3014 | |
(913) 755-3015 |
Full Name | |
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Speciality | Dentist |
Location | 301 E Main St, Osawatomie, Kansas |
Authorized Official Name and Position | Deanna M Barden (DENTIST/MEMBER/OWNER) |
Authorized Official Contact | 9137553014 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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301 E Main St Po Box 400 Osawatomie KS 66064-1129 Ph: (913) 755-3014 | 301 E Main St Osawatomie KS 66064-1129 Ph: (913) 755-3014 |
NPI Number | 1336597046 |
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Provider Enumeration Date | 06/03/2016 |
Last Update Date | 06/03/2016 |
Medicare PECOS PAC ID | 4587105903 |
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Medicare Enrollment ID | O20240925000817 |
Identifier | Type | State | Issuer |
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1336597046 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 61202 (Kansas) | Primary |