MEDICARE: NED TODOROV DDS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	60460	KS

General Provider Information

NPI Number	:	1013261445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NED TODOROV DDS LLC

Provider Business Mailing Address
First Line	:	9390 E CENTRAL AVE STE 100
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-2565
Country	:	US
Telephone Number	:	316-686-3140
Fax Number	:

Provider Business Practice Location Address
First Line	:	9390 E CENTRAL AVE STE 100
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-2565
Country	:	US
Telephone Number	:	316-686-3140
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CINDY RODUNER
Credential	:
Telephone Number	:	316-686-3140

Provider Enumeration Date	:	11/07/2012
Last Update Date	:	11/07/2012

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