| |
309 S 2nd St Leavenworth KS 66048-2803 | |
(913) 651-9800 | |
(913) 651-8559 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 309 S 2nd St, Leavenworth, Kansas |
Authorized Official Name and Position | Jennifer Ann Kirwan (DENTIST) |
Authorized Official Contact | 9136519800 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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309 S 2nd St Leavenworth KS 66048-2803 Ph: (913) 651-9800 | 309 S 2nd St Leavenworth KS 66048-2803 Ph: (913) 651-9800 |
NPI Number | 1649674144 |
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Provider Enumeration Date | 10/14/2014 |
Last Update Date | 10/14/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649674144 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (Kansas) | Primary |
1223P0221X | Dentist - Pediatric Dentistry | (Kansas) | Secondary |
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