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General NPI Number Information
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NPI Number | 1962825927
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Entity Type | Organization
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Legal Business Name | JOAN HOVERMAN, DDS
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Dates
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Enumeration Date | 01/28/2014
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Last Update Date | 01/28/2014
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Provider Practice Location Address
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Address Line | 4100 W MAPLE ST C/O FAMILY DENTISTRY & PREVENTIVE CARE BUILDING
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City | WICHITA
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State | KS
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Zip | 67209-2538
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Country | US
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Telephone | 316-530-3191
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Fax | 316-854-0821
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Provider Business Mailing Address
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Address Line | 4100 W MAPLE ST C/O FAMILY DENTISTRY & PREVENTIVE CARE
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City | WICHITA
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State | KS
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Zip | 67209-2538
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Country | US
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Telephone | 316-530-3191
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Fax |
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Authorized Official
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Title or Position | OWNER / OPERATOR
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Name | DR. JOAN HOVERMAN
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Credential | DDS
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Telephone | 316-530-3191
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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 | 60251
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License Number State | KS
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