| Ottawa Kansas Dentistry | |
|
1334 S Main St Ottawa KS 66067-3527 | |
| (785) 242-5753 | |
| Not Available |
| Full Name | Ottawa Kansas Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1334 S Main St, Ottawa, Kansas |
| Authorized Official Name and Position | Jessica Marie Johnson (PRESIDENT) |
| Authorized Official Contact | 7857661031 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ottawa Kansas Dentistry 1334 S Main St Ottawa KS 66067-3527 Ph: (785) 242-5753 | Ottawa Kansas Dentistry 1334 S Main St Ottawa KS 66067-3527 Ph: (785) 242-5753 |
| NPI Number | 1225559818 |
|---|---|
| Provider Enumeration Date | 07/04/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225559818 | NPI | - | NPPES |
| 61001 | Other | KS | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 61001 (Kansas) | Primary |
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