Provider Demographics
NPI:1194061804
Name:NEW HORIZONS DENTAL CARE
Entity type:Organization
Organization Name:NEW HORIZONS DENTAL CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:W
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-825-7197
Mailing Address - Street 1:1920 S OHIO ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-6643
Mailing Address - Country:US
Mailing Address - Phone:785-825-7197
Mailing Address - Fax:785-827-9400
Practice Address - Street 1:19613 W 101ST ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66220-8600
Practice Address - Country:US
Practice Address - Phone:913-390-5110
Practice Address - Fax:913-390-5664
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW HORIZONS DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-27
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60323122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty