| Smile Craft Dental, Llc | |
|
5315 E 21st St N Ste 104 Wichita KS 67208-1600 | |
| (408) 209-2855 | |
| Not Available |
| Full Name | Smile Craft Dental, Llc |
|---|---|
| Speciality | Dentist |
| Location | 5315 E 21st St N Ste 104, Wichita, Kansas |
| Authorized Official Name and Position | Cindy Le (OFFICE MANAGER) |
| Authorized Official Contact | 4082092855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Craft Dental, Llc 5315 E 21st St N Ste 104 Wichita KS 67208-1600 Ph: (408) 209-2855 | Smile Craft Dental, Llc 5315 E 21st St N Ste 104 Wichita KS 67208-1600 Ph: (408) 209-2855 |
| NPI Number | 1861014367 |
|---|---|
| Provider Enumeration Date | 05/07/2020 |
| Last Update Date | 05/07/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861014367 | NPI | - | NPPES |
| 200877840C | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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