Provider First Line Business Practice Location Address:
3507 S 4TH ST
Provider Second Line Business Practice Location Address:
HEARTLAND DENTAL GROUP
Provider Business Practice Location Address City Name:
LEAVENWORTH
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66048-5013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-682-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2009