| Matthew E Robertson Dmd Llc | |
|
3510 N Ridge Rd Ste 500 Wichita KS 67205-1224 | |
| (316) 722-0800 | |
| (316) 722-5822 |
| Full Name | Matthew E Robertson Dmd Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3510 N Ridge Rd, Wichita, Kansas |
| Authorized Official Name and Position | Matthew E Robertson (OWNER) |
| Authorized Official Contact | 3167220800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew E Robertson Dmd Llc 3510 N Ridge Rd Ste 500 Wichita KS 67205-1224 Ph: (316) 722-0800 | Matthew E Robertson Dmd Llc 3510 N Ridge Rd Ste 500 Wichita KS 67205-1224 Ph: (316) 722-0800 |
| NPI Number | 1275892671 |
|---|---|
| Provider Enumeration Date | 05/07/2012 |
| Last Update Date | 06/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275892671 | NPI | - | NPPES |
| 200557210A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 60512 (Kansas) | Primary |
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