| Illuminate Family Dentistry, Llc | |
|
250 W Red Powell Dr Ste 500 Derby KS 67037-2626 | |
| (316) 847-7730 | |
| Not Available |
| Full Name | Illuminate Family Dentistry, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 250 W Red Powell Dr Ste 500, Derby, Kansas |
| Authorized Official Name and Position | Rachel Hayes Clark (OWNER DENTIST) |
| Authorized Official Contact | 3168477730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuminate Family Dentistry, Llc 2113 N Woodard St Derby KS 67037-2364 Ph: () - | Illuminate Family Dentistry, Llc 250 W Red Powell Dr Ste 500 Derby KS 67037-2626 Ph: (316) 847-7730 |
| NPI Number | 1316691736 |
|---|---|
| Provider Enumeration Date | 02/04/2022 |
| Last Update Date | 02/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316691736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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