| Periodontist Pa | |
|
10870 Benson St Bldg. 21 Suite 2100 Overland Park KS 66210-1502 | |
| (913) 451-6158 | |
| (913) 451-9463 |
| Full Name | Periodontist Pa |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 10870 Benson St, Overland Park, Kansas |
| Authorized Official Name and Position | Stanley L Wint (PRESIDENT) |
| Authorized Official Contact | 9134516158 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Periodontist Pa 10870 Benson St Bldg. 21 Suite 2100 Overland Park KS 66210-1502 Ph: (913) 451-6158 | Periodontist Pa 10870 Benson St Bldg. 21 Suite 2100 Overland Park KS 66210-1502 Ph: (913) 451-6158 |
| NPI Number | 1104948959 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104948959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 5544 (Kansas) | Primary |
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