MEDICARE: DR. RONALD EMERSON WHITCOMB D.D.S.

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	1223G0001X	General Practice Dentistry	5131	KS

General Provider Information

NPI Number	:	1134107428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD EMERSON WHITCOMB D.D.S.

Provider Business Mailing Address
First Line	:	9411 W NANTUCKET ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67212-1052
Country	:	US
Telephone Number	:	316-722-1277
Fax Number	:

Provider Business Practice Location Address
First Line	:	3722 N ARKANSAS AVE
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67204-4053
Country	:	US
Telephone Number	:	316-832-0186
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. RONALD EMERSON WHITCOMB D.D.S.” Practice Location

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