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General NPI Number Information
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NPI Number | 1598998130
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Entity Type | Organization
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Legal Business Name | SHAWNEE ORAL SURGERY, LC
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Dates
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Enumeration Date | 08/31/2009
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Last Update Date | 07/01/2010
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Provider Practice Location Address
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Address Line | 6844 SILVERHEEL STREET
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City | SHAWNEE
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State | KS
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Zip | 66226-5300
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Country | US
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Telephone | 913-948-7766
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Fax | 913-948-7769
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Provider Business Mailing Address
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Address Line | 6844 SILVERHEEL STREET
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City | SHAWNEE
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State | KS
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Zip | 66226-5300
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Country | US
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Telephone | 913-948-7766
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Fax | 913-948-7769
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Authorized Official
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Title or Position | ORAL AND MAXILLOFACIAL SURGEON
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Name | PHILIP C GAUS
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Credential |
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Telephone | 785-979-9494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number |
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License Number State |
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