Provider Demographics
NPI:1154165355
Name:ABILENE DENTAL ARTS LLC
Entity type:Organization
Organization Name:ABILENE DENTAL ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-342-0430
Mailing Address - Street 1:11 RED FOX LN
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-6619
Mailing Address - Country:US
Mailing Address - Phone:785-342-0430
Mailing Address - Fax:
Practice Address - Street 1:203 N BUCKEYE AVE
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410-2544
Practice Address - Country:US
Practice Address - Phone:785-342-0430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental