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301 N Main St Suite 1420 Wichita KS 67202-4800 | |
| (316) 265-0849 | |
| (316) 265-6307 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 301 N Main St, Wichita, Kansas |
| Authorized Official Name and Position | John M Lewis (PRESIDENT) |
| Authorized Official Contact | 3162650849 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
301 N Main St Suite 1420 Wichita KS 67202-4800 Ph: (316) 265-0849 | 301 N Main St Suite 1420 Wichita KS 67202-4800 Ph: (316) 265-0849 |
| NPI Number | 1528310331 |
|---|---|
| Provider Enumeration Date | 10/04/2012 |
| Last Update Date | 10/04/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528310331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6445 (Kansas) | Primary |
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