Ict Dentistry LLC
Dentist, General Practice in Wichita, KS. Organization (NPI-2).
NPI number1558092940
StatusActive
Last updated in NPPESJun 20, 2023
Details
- NPI
- 1558092940
- Entity type
- Organization (NPI-2)
- Legal business name
- Ict Dentistry LLC
- Organization subpart
- No
- Enumeration date
- Jun 17, 2022
- Certification date
- Jun 20, 2023
- Last updated
- Jun 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
3151 N Rock RdWichita, KS 67226-1312
Phone 316-272-7876
Mailing address
Po Box 70887Cleveland, OH 44190-0887
Authorized official
Trenton Ebersole
Owner
3162727876
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