Provider Demographics
NPI:1194791251
Name:YOWELL DENTAL GROUP P.A.
Entity type:Organization
Organization Name:YOWELL DENTAL GROUP P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:V
Authorized Official - Last Name:YOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:620-241-0842
Mailing Address - Street 1:1540 NORTH MAIN
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460
Mailing Address - Country:US
Mailing Address - Phone:620-241-0842
Mailing Address - Fax:620-241-0887
Practice Address - Street 1:1540 NORTH MAIN
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460
Practice Address - Country:US
Practice Address - Phone:620-241-0842
Practice Address - Fax:620-241-0887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS64351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty