| Prairie Vista Dental, Llc | |
|
209 W Central Ave Uysses KS 67880 | |
| (620) 424-4311 | |
| Not Available |
| Full Name | Prairie Vista Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 209 W Central Ave, Uysses, Kansas |
| Authorized Official Name and Position | Bret J Holman (DENTIST/OWNER) |
| Authorized Official Contact | 6204244311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Vista Dental, Llc 209 W Central Ave Ulysses KS 67880-2403 Ph: () - | Prairie Vista Dental, Llc 209 W Central Ave Uysses KS 67880 Ph: (620) 424-4311 |
| NPI Number | 1255648036 |
|---|---|
| Provider Enumeration Date | 09/01/2010 |
| Last Update Date | 11/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255648036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 60655 (Kansas) | Primary |