| Perlita M. Dutton, Dds, Pa | |
|
23 Professional Dr Suite A Liberal KS 67901-1803 | |
| (620) 626-4700 | |
| (620) 624-2474 |
| Full Name | Perlita M. Dutton, Dds, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 23 Professional Dr, Liberal, Kansas |
| Authorized Official Name and Position | Perlita M Dutton (PRESIDENT) |
| Authorized Official Contact | 6206264700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Perlita M. Dutton, Dds, Pa 23 Professional Dr Suite A Liberal KS 67901-1803 Ph: (620) 626-4700 | Perlita M. Dutton, Dds, Pa 23 Professional Dr Suite A Liberal KS 67901-1803 Ph: (620) 626-4700 |
| NPI Number | 1417165713 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417165713 | NPI | - | NPPES |
| 420776 | Other | KS | BCBS OF KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5895 (Kansas) | Primary |
First Avenue Dental, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 23 E 11th St, Liberal, KS 67901 Phone: 620-604-9279 Fax: 620-417-9616 |