| Wichita Family Dental Derby | |
|
1120 N Rock Rd Ste 100 Derby KS 67037-3587 | |
| (316) 333-6446 | |
| Not Available |
| Full Name | Wichita Family Dental Derby |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1120 N Rock Rd Ste 100, Derby, Kansas |
| Authorized Official Name and Position | William Little (CEO) |
| Authorized Official Contact | 8702936264 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wichita Family Dental Derby Po Box 17151 Jonesboro AR 72403-6720 | Wichita Family Dental Derby 1120 N Rock Rd Ste 100 Derby KS 67037-3587 Ph: (316) 333-6446 |
| NPI Number | 1316627177 |
|---|---|
| Provider Enumeration Date | 07/18/2023 |
| Last Update Date | 07/18/2023 |
| Certification Date | 07/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316627177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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