| Cental Kansas Dentistry, Pa | |
|
202 N Douglas Ave Ellsworth KS 67439-3216 | |
| (785) 472-3803 | |
| (785) 472-3620 |
| Full Name | Cental Kansas Dentistry, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 202 N Douglas Ave, Ellsworth, Kansas |
| Authorized Official Name and Position | Kurt Allen Williams (OWNER) |
| Authorized Official Contact | 7854723803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cental Kansas Dentistry, Pa 202 N Douglas Ave Ellsworth KS 67439-3216 Ph: (785) 472-3803 | Cental Kansas Dentistry, Pa 202 N Douglas Ave Ellsworth KS 67439-3216 Ph: (785) 472-3803 |
| NPI Number | 1285682773 |
|---|---|
| Provider Enumeration Date | 05/05/2006 |
| Last Update Date | 09/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285682773 | NPI | - | NPPES |
| 19253 | Other | KS | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6652 (Kansas) | Primary |
Mark A.herzog Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 804 E 8th St, Ellsworth, KS 67439 Phone: 785-472-5420 Fax: 785-472-8995 |