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General NPI Number Information
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NPI Number | 1740617612
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Entity Type | Organization
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Legal Business Name | GREGORY J PARTRIDGE DDS, ESTATE
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Dates
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Enumeration Date | 10/08/2013
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Last Update Date | 10/08/2013
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Provider Practice Location Address
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Address Line | 841 S HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67211-3005
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Country | US
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Telephone | 316-681-1530
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Fax | 316-682-5231
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Provider Business Mailing Address
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Address Line | 841 S HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67211-3005
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Country | US
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Telephone | 316-681-1530
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Fax | 316-682-5231
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TERESA L ROSE
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Credential |
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Telephone | 425-238-7426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6123
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License Number State | KS
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