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NPI Code Detail

MEDICARE: DR. KENNETH L WILLIAMS DDS

MEDICARE: DR. KENNETH L WILLIAMS 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
11223G0001XGeneral Practice Dentistry6093KS

General Provider Information

NPI Number : 1801099189
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH L WILLIAMS DDS
Provider Business Mailing Address
First Line : 2607 S SANTA FE AVE
Second Line :
City : CHANUTE
State : KS
Zip : 66720-3206
Country : US
Telephone Number : 620-431-3000
Fax Number : 620-431-6122
Provider Business Practice Location Address
First Line : 2607 S SANTA FE AVE
Second Line :
City : CHANUTE
State : KS
Zip : 66720-3206
Country : US
Telephone Number : 620-431-3000
Fax Number : 620-431-6122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2007
Last Update Date : 01/23/2014

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