| Sttt Dental Services Llc Corp | |
|
120 W Osage St Sedan KS 67361-1518 | |
| (620) 725-3122 | |
| (620) 725-5395 |
| Full Name | Sttt Dental Services Llc Corp |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 120 W Osage St, Sedan, Kansas |
| Authorized Official Name and Position | Colin Michael Shawhan (DENTIST) |
| Authorized Official Contact | 6207253122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sttt Dental Services Llc Corp 120 W Osage St Sedan KS 67361-1518 Ph: (620) 725-3122 | Sttt Dental Services Llc Corp 120 W Osage St Sedan KS 67361-1518 Ph: (620) 725-3122 |
| NPI Number | 1871948497 |
|---|---|
| Provider Enumeration Date | 05/02/2016 |
| Last Update Date | 11/07/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871948497 | NPI | - | NPPES |
| 201126710A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 305S00000X | Point Of Service | 61288 (Kansas) | Secondary |
Gabriel Wurdeman Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 W Osage St, Sedan, KS 67361 Phone: 620-725-3122 Fax: 620-725-5395 | |
Chautauqua Hills Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 W Osage St, Sedan, KS 67361 Phone: 620-725-3122 Fax: 620-725-5395 |