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General NPI Number Information
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NPI Number | 1649437591
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Entity Type | Organization
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Legal Business Name | SOUTH TOPEKA DENTAL CARE
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 1401 SW 37TH ST
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City | TOPEKA
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State | KS
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Zip | 66611-2624
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Country | US
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Telephone | 785-266-3533
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Fax | 785-266-9227
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Provider Business Mailing Address
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Address Line | 1401 SW 37TH ST
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City | TOPEKA
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State | KS
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Zip | 66611-2624
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Country | US
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Telephone | 785-266-3533
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Fax | 785-266-9227
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD JOHN PERKINS
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Credential | DDS
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Telephone | 785-266-3533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 60524
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License Number State | KS
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