Provider Demographics
NPI:1265443055
Name:KANSAS ENDODONTICS,LLC
Entity Type:Organization
Organization Name:KANSAS ENDODONTICS,LLC
Other - Org Name:LAWRENCE ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:GATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-843-8610
Mailing Address - Street 1:4830 QUAIL CREST PL
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3838
Mailing Address - Country:US
Mailing Address - Phone:785-843-8610
Mailing Address - Fax:785-843-8611
Practice Address - Street 1:4830 QUAIL CREST PL
Practice Address - Street 2:SUITE B
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-3838
Practice Address - Country:US
Practice Address - Phone:785-843-8610
Practice Address - Fax:785-843-8611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS69441223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty