Lauren Kirsten Wilson, DDS

Individual provider Active NPI General Practice Dentistry · Park City, KS

NPI 1780424432 · NPPES record last updated May 30, 2024

Key facts

NPI
1780424432
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
62123 (KS)
Practice address
410 E 61St St N
Park City, KS 67219-1906
Phone
(316) 744-0001
NPI assigned
May 30, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
62123KSMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 62123 KS Yes

Addresses

Primary practice location

410 E 61St St N
Park City, KS 67219-1906

Mailing address

410 E 61St St N
Park City, KS 67219-1906
Phone (316) 744-0001

Other providers in Park City, KS

All providers in Park City, KS · General Practice Dentistry in Kansas

Sources for this page

Verify at the official NPI Registry.