| First Avenue Dental, P.a. | |
|
23 E 11th St Liberal KS 67901-2720 | |
| (620) 604-9279 | |
| (620) 417-9616 |
| Full Name | First Avenue Dental, P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 23 E 11th St, Liberal, Kansas |
| Authorized Official Name and Position | Ryan Lehmkuhler (PRESIDENT) |
| Authorized Official Contact | 6203716630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| First Avenue Dental, P.a. 23 E 11th St Liberal KS 67901-2720 Ph: (620) 604-9279 | First Avenue Dental, P.a. 23 E 11th St Liberal KS 67901-2720 Ph: (620) 604-9279 |
| NPI Number | 1275199168 |
|---|---|
| Provider Enumeration Date | 05/15/2019 |
| Last Update Date | 08/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275199168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Perlita M. Dutton, Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 23 Professional Dr, Suite A, Liberal, KS 67901 Phone: 620-626-4700 Fax: 620-624-2474 |