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General NPI Number Information
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NPI Number | 1801330980
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Entity Type | Organization
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Legal Business Name | SMILE CONNECTIONS FAMILY DENTAL, L.L.C.
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Dates
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Enumeration Date | 12/08/2016
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 250 N TYLER RD
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City | WICHITA
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State | KS
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Zip | 67212-3753
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Country | US
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Telephone | 316-722-8148
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Fax | 316-773-0883
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Provider Business Mailing Address
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Address Line | 250 N TYLER RD
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City | WICHITA
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State | KS
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Zip | 67212-3753
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Country | US
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Telephone | 316-722-8148
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Fax | 316-773-0883
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | JAMES A VOLKER
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Credential | D.D.S.
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Telephone | 316-722-8148
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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 | 60254
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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 | 7170
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License Number State | KS
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