BRAISDANALLC
Organization (NPI-2)
Active
Dentist, General Practice
Provider Information
- NPI Number
1992195234- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 13605 W MAPLE ST SUITE 107 & 109, WICHITA, KS, 672358759
- Phone
- (316) 304-1582
Specialties & Taxonomies
Dentist, General Practice
Primary License: KS #61092