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General NPI Number Information
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NPI Number | 1982879664
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Entity Type | Organization
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Legal Business Name | RICHARD J. ACKERMAN, JR. D.D.S.,M.S.,P.A.
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 705 1ST AVE SUITE B
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City | DODGE CITY
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State | KS
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Zip | 67801-4437
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Country | US
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Telephone | 620-227-2234
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Fax | 620-227-8284
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Provider Business Mailing Address
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Address Line | 705 1ST AVE SUITE B
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City | DODGE CITY
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State | KS
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Zip | 67801-4437
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Country | US
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Telephone | 620-227-2234
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Fax | 620-227-8284
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Authorized Official
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Title or Position | PRESIDENT-ORTHODONTIST
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Name | DR. RICHARD J. ACKERMAN JR.
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Credential | DDS,MS
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Telephone | 620-227-2234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 4382
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License Number State | KS
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