Healthcare Provider Details

I. General information

NPI: 1396842142
Provider Name (Legal Business Name): MINER FAMILY DENTISTRY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 DOWNING AVE STE 10
HAYS KS
67601-2461
US

IV. Provider business mailing address

1010 DOWNING AVE STE 10
HAYS KS
67601-2461
US

V. Phone/Fax

Practice location:
  • Phone: 785-625-2200
  • Fax: 785-625-0079
Mailing address:
  • Phone: 785-625-2200
  • Fax: 785-625-0079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MELINDA KAY MINER
Title or Position: OWNER
Credential: D.D.S.
Phone: 785-625-2200