Provider Demographics
NPI:1033127485
Name:CANTERBURY ORAL & MAXILLOFACIAL SURGERY
Entity Type:Organization
Organization Name:CANTERBURY ORAL & MAXILLOFACIAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUXMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-628-1079
Mailing Address - Street 1:2901 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2152
Mailing Address - Country:US
Mailing Address - Phone:785-628-1079
Mailing Address - Fax:785-628-1090
Practice Address - Street 1:2901 CANTERBURY DR
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2152
Practice Address - Country:US
Practice Address - Phone:785-628-1079
Practice Address - Fax:785-628-1090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1629057088OtherRONALD L. ROHOLT, DDS, MD
KS1043263858OtherCRAIG E. MILLER, DDS
KS1306825476OtherKURT MARTIN, DDS, MD
KS1043263858OtherCRAIG E. MILLER, DDS