| Heartland Dental Group | |
|
3507 S 4th St Leavenworth KS 66048-5013 | |
| (913) 682-1000 | |
| (913) 682-6131 |
| Full Name | Heartland Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 3507 S 4th St, Leavenworth, Kansas |
| Authorized Official Name and Position | Mark Ernzen (ADMINISTRATOR) |
| Authorized Official Contact | 9136821000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartland Dental Group 3507 S 4th St Leavenworth KS 66048-5013 Ph: (913) 682-1000 | Heartland Dental Group 3507 S 4th St Leavenworth KS 66048-5013 Ph: (913) 682-1000 |
| NPI Number | 1245317650 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245317650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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