Healthcare Provider Details

I. General information

NPI: 1063624989
Provider Name (Legal Business Name): ROBERT M. WOOD, DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2445 SW WANAMAKER RD
TOPEKA KS
66614-5470
US

IV. Provider business mailing address

2445 SW WANAMAKER RD
TOPEKA KS
66614-5470
US

V. Phone/Fax

Practice location:
  • Phone: 785-273-9717
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT M WOOD
Title or Position: OWNER
Credential: D.D.S
Phone: 785-273-9717