| Wakarusa Oral Surgery, Lc | |
|
4901 Legends Dr Lawrence KS 66049-5800 | |
| (785) 856-6010 | |
| Not Available |
| Full Name | Wakarusa Oral Surgery, Lc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 4901 Legends Dr, Lawrence, Kansas |
| Authorized Official Name and Position | Philip Charles Gaus (MANAGER/MEMBER) |
| Authorized Official Contact | 7858566010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wakarusa Oral Surgery, Lc 4901 Legends Dr Lawrence KS 66049-5800 Ph: (785) 856-6010 | Wakarusa Oral Surgery, Lc 4901 Legends Dr Lawrence KS 66049-5800 Ph: (785) 856-6010 |
| NPI Number | 1306076971 |
|---|---|
| Provider Enumeration Date | 07/17/2009 |
| Last Update Date | 07/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306076971 | NPI | - | NPPES |
| 100224610B | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 6706 (Kansas) | Primary |
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