| Sweet Tooth Shawnee, Llc | |
|
15933 W 65th St Shawnee KS 66217-9342 | |
| (913) 239-0703 | |
| Not Available |
| Full Name | Sweet Tooth Shawnee, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 15933 W 65th St, Shawnee, Kansas |
| Authorized Official Name and Position | Wayne Robert Dobbins (CEO) |
| Authorized Official Contact | 4803435072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sweet Tooth Shawnee, Llc 15933 W 65th St Shawnee KS 66217-9342 Ph: (913) 239-0703 | Sweet Tooth Shawnee, Llc 15933 W 65th St Shawnee KS 66217-9342 Ph: (913) 239-0703 |
| NPI Number | 1881279461 |
|---|---|
| Provider Enumeration Date | 03/15/2021 |
| Last Update Date | 03/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881279461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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