| El Dorado Family Dentistry P.a. | |
|
202 N Main St El Dorado KS 67042-2018 | |
| (316) 321-0300 | |
| (316) 321-1010 |
| Full Name | El Dorado Family Dentistry P.a. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 202 N Main St, El Dorado, Kansas |
| Authorized Official Name and Position | Louis Steve Latimer (OWNER) |
| Authorized Official Contact | 3163211010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| El Dorado Family Dentistry P.a. 202 N Main St El Dorado KS 67042-2018 Ph: (316) 321-0300 | El Dorado Family Dentistry P.a. 202 N Main St El Dorado KS 67042-2018 Ph: (316) 321-0300 |
| NPI Number | 1285828608 |
|---|---|
| Provider Enumeration Date | 08/29/2007 |
| Last Update Date | 08/29/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285828608 | NPI | - | NPPES |
| 17426 | Other | KS | BCBS |
| 17428 | Other | KS | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5311 (Kansas) | Primary |
El Dorado Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 N Main St, El Dorado, KS 67042 Phone: 316-321-0300 | |
R.m. Moody,dds/el Dorado Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 122 N Taylor St, El Dorado, KS 67042 Phone: 316-320-3636 Fax: 316-320-3636 |