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General NPI Number Information
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NPI Number | 1558576934
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Entity Type | Organization
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Legal Business Name | FLINT HILLS DENTAL CARE, PA
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2518 W 15TH AVE
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City | EMPORIA
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State | KS
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Zip | 66801-6102
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Country | US
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Telephone | 620-343-8000
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Fax | 620-343-9511
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Provider Business Mailing Address
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Address Line | 2518 W 15TH AVE
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City | EMPORIA
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State | KS
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Zip | 66801-6102
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Country | US
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Telephone | 620-343-8000
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Fax | 620-343-9511
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD D BARDEN
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Credential | DDS
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Telephone | 620-343-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 60357
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4991
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License Number State | KS
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