| Michael J Dostal DDS, LLC | |
|
5408 Roberts St Shawnee KS 66226-3937 | |
| (785) 550-2682 | |
| Not Available |
| Full Name | Michael J Dostal DDS, LLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5408 Roberts St, Shawnee, Kansas |
| Authorized Official Name and Position | Michael Dostal (SOLE MEMBER) |
| Authorized Official Contact | 7855502682 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael J Dostal DDS, LLC 5408 Roberts St Shawnee KS 66226-3937 | Michael J Dostal DDS, LLC 5408 Roberts St Shawnee KS 66226-3937 Ph: (785) 550-2682 |
| NPI Number | 1164712485 |
|---|---|
| Provider Enumeration Date | 04/08/2011 |
| Last Update Date | 04/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164712485 | NPI | - | NPPES |
| 200698320A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 60656 (Kansas) | Primary |
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