| Eric J. Wisdom D.d.s., P.a. | |
|
1629 Poyntz Ave Manhattan KS 66502-4148 | |
| (785) 776-1771 | |
| (785) 539-3905 |
| Full Name | Eric J. Wisdom D.d.s., P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1629 Poyntz Ave, Manhattan, Kansas |
| Authorized Official Name and Position | Eric J Wisdom (OWNER) |
| Authorized Official Contact | 7857761771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eric J. Wisdom D.d.s., P.a. 1629 Poyntz Ave Manhattan KS 66502-4148 Ph: (785) 776-1771 | Eric J. Wisdom D.d.s., P.a. 1629 Poyntz Ave Manhattan KS 66502-4148 Ph: (785) 776-1771 |
| NPI Number | 1861418469 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 11/29/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861418469 | NPI | - | NPPES |
| 100095990C | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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