NPI Profile for MID KANSAS ORAL MAXILLOFACIAL SURGERY LLC in WICHITA, KS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery |
| NPI Number | 1881258366 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/30/2019 | |
| Last updated | 11/12/2019 - About 7 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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