| Northern California Dental Sleep Therapy Center | |
|
1619 N Waterfront Pkwy Wichita KS 67206-6602 | |
| (916) 517-9905 | |
| Not Available |
| Full Name | Northern California Dental Sleep Therapy Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1619 N Waterfront Pkwy, Wichita, Kansas |
| Authorized Official Name and Position | Preddis Leroy Sullivan (PRESIDENT) |
| Authorized Official Contact | 9165179905 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern California Dental Sleep Therapy Center 3620 N Crest Ct Wichita KS 67226-1019 Ph: (916) 517-9905 | Northern California Dental Sleep Therapy Center 1619 N Waterfront Pkwy Wichita KS 67206-6602 Ph: (916) 517-9905 |
| NPI Number | 1326354754 |
|---|---|
| Provider Enumeration Date | 08/23/2010 |
| Last Update Date | 10/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326354754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 54500 (California) | Primary |
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