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General NPI Number Information
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NPI Number | 1518473875
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Entity Type | Organization
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Legal Business Name | VAUGHN PEDIATRIC DENTISTRY LLC
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Dates
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Enumeration Date | 12/22/2017
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Last Update Date | 04/15/2021
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Provider Practice Location Address
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Address Line | 6231 SW 29TH ST STE 100
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City | TOPEKA
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State | KS
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Zip | 66614-4549
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Country | US
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Telephone | 785-272-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 6231 SW 29TH ST STE 100
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City | TOPEKA
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State | KS
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Zip | 66614-4549
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | LAURA VAUGHN
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Credential | DDS
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Telephone | 617-501-3934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 61062
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License Number State | KS
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