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2300 N 14th Street Suite 202 Dodge City KS 67801 | |
| (620) 225-2650 | |
| (620) 225-7722 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2300 N 14th Street, Dodge City, Kansas |
| Authorized Official Name and Position | Toni Myers (OFFICE MANAGER) |
| Authorized Official Contact | 6202252650 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2300 N 14th Street Suite 202 Dodge City KS 67801 Ph: (620) 225-2650 | 2300 N 14th Street Suite 202 Dodge City KS 67801 Ph: (620) 225-2650 |
| NPI Number | 1477621159 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477621159 | NPI | - | NPPES |
| 116721 | Other | KS | BCBS OF KS |
| KS1417934 | Other | KS | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 60130 (* (Not Available)) | Primary |
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