| Country Club Dental Pa | |
|
400 Sw 29th St Suite M Topeka KS 66611-1164 | |
| (785) 783-5981 | |
| (785) 783-5982 |
| Full Name | Country Club Dental Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 400 Sw 29th St, Topeka, Kansas |
| Authorized Official Name and Position | Shaun Urbanozo (CREDENTIALING MANAGER) |
| Authorized Official Contact | 7193232362 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Country Club Dental Pa 2221 E Bijou St Ste 100 Colorado Springs CO 80909-8009 Ph: (719) 576-1850 | Country Club Dental Pa 400 Sw 29th St Suite M Topeka KS 66611-1164 Ph: (785) 783-5981 |
| NPI Number | 1699137109 |
|---|---|
| Provider Enumeration Date | 03/23/2016 |
| Last Update Date | 09/09/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699137109 | NPI | - | NPPES |
| 201199030A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (Kansas) | Primary |
Paul W Heath, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2714 Nw Topeka Blvd, Topeka, KS 66617 Phone: 785-234-5410 Fax: 785-234-9274 | |
Larry C. Hargreaves, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 Sw 37th St, Topeka, KS 66611 Phone: 785-266-3533 Fax: 785-266-9227 | |
Kelly B Deeter, Dds, Chtd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2300 Sw 29th, Topeka, KS 66611 Phone: 785-267-6120 Fax: 785-267-6928 | |
Holden Correll Dds Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1107 Sw Gage Blvd, Suite 100, Topeka, KS 66604 Phone: 785-271-7477 | |
Robert R. Lohse, Jr., D.d.s., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5100 Sw 28th St, Topeka, KS 66614 Phone: 785-271-1002 Fax: 785-271-8889 | |
Marian Clinic, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3164 Se 6th Ave, Topeka, KS 66607 Phone: 785-233-2800 Fax: 785-233-5116 | |
Robert M. Wood, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2445 Sw Wanamaker Rd, Topeka, KS 66614 Phone: 785-273-9717 |