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140 N 130th St Bonner Springs KS 66012-9142 | |
| (913) 721-1300 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 140 N 130th St, Bonner Springs, Kansas |
| Authorized Official Name and Position | Thomas Drake (DENTIST) |
| Authorized Official Contact | 9137211300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
140 N 130th St Bonner Springs KS 66012-9142 Ph: () - | 140 N 130th St Bonner Springs KS 66012-9142 Ph: (913) 721-1300 |
| NPI Number | 1124514526 |
|---|---|
| Provider Enumeration Date | 07/09/2018 |
| Last Update Date | 07/09/2018 |
| Medicare PECOS PAC ID | 3173875804 |
|---|---|
| Medicare Enrollment ID | O20181009000339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124514526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
Blum Family Dentistry, L.l.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 216 E 2nd St, Bonner Springs, KS 66012 Phone: 913-422-5066 Fax: 913-422-8176 | |
Dr Hartman & Associates Dentistry, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13031 Kansas Ave, Bonner Springs, KS 66012 Phone: 913-441-1600 Fax: 913-441-1628 |