| NPI | 1194365817 |
|---|---|
| Other Name | WICHITA FAMILY DENTAL SOUTH |
| Other Name | DERBY DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE N BRANDES Clinical Director 316-630-9339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2020-01-10 |