MEDICARE: DR. WILLIAM E HARTMAN DDS

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	6245	KS

General Provider Information

NPI Number	:	1184607053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM E HARTMAN DDS

Provider Business Mailing Address
First Line	:	5732 WIDMER RD
Second Line	:
City	:	SHAWNEE
State	:	KS
Zip	:	66216-3868
Country	:	US
Telephone Number	:	913-631-2709
Fax Number	:

Provider Business Practice Location Address
First Line	:	13031 KANSAS AVE
Second Line	:
City	:	BONNER SPRINGS
State	:	KS
Zip	:	66012-9206
Country	:	US
Telephone Number	:	913-441-1600
Fax Number	:	913-441-1628

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

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	07/08/2007

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