Healthcare Provider Details
I. General information
NPI: 1194049940
Provider Name (Legal Business Name): TOPEKA ENDODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/23/2010
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6231 SW 29TH ST STE 300
TOPEKA KS
66614-4684
US
IV. Provider business mailing address
6231 SW 29TH ST STE 300
TOPEKA KS
66614-4684
US
V. Phone/Fax
- Phone: 785-215-8441
- Fax:
- Phone: 785-215-8441
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KRISTY
LIND
MARKER
Title or Position: PRESIDENT
Credential: DDS, MS
Phone: 785-215-8441