| Custom Dental Of Ottawa, Pa | |
|
2030 S Princeton St Ottawa KS 66067 | |
| (785) 521-3737 | |
| Not Available |
| Full Name | Custom Dental Of Ottawa, Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2030 S Princeton St, Ottawa, Kansas |
| Authorized Official Name and Position | Rene Rodgers (COO) |
| Authorized Official Contact | 4052276100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Dental Of Ottawa, Pa 2030 S Princeton St Ottawa KS 66067 Ph: (785) 521-3737 | Custom Dental Of Ottawa, Pa 2030 S Princeton St Ottawa KS 66067 Ph: (785) 521-3737 |
| NPI Number | 1508419938 |
|---|---|
| Provider Enumeration Date | 07/24/2019 |
| Last Update Date | 09/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508419938 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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