Healthcare Provider Details

I. General information

NPI: 1366517187
Provider Name (Legal Business Name): TOPEKA ORAL SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 SW VILLA WEST DR STE A
TOPEKA KS
66614-4487
US

IV. Provider business mailing address

3033 SW VILLA WEST DR STE A
TOPEKA KS
66614-4487
US

V. Phone/Fax

Practice location:
  • Phone: 785-228-0500
  • Fax: 785-228-1313
Mailing address:
  • Phone: 785-228-0500
  • Fax: 785-228-1313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN D ZELLER
Title or Position: OWNER
Credential: D.D.S.
Phone: 785-228-0500