Provider Demographics
NPI:1215915392
Name:DUGAN, STEPHEN P (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:P
Last Name:DUGAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7405 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212
Mailing Address - Country:US
Mailing Address - Phone:316-773-2244
Mailing Address - Fax:316-773-2087
Practice Address - Street 1:7405 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212
Practice Address - Country:US
Practice Address - Phone:316-773-2244
Practice Address - Fax:316-773-2087
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS601381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice