Provider Demographics
NPI:1437734084
Name:SWEET TOOTH ORTHODONTICS INC.
Entity Type:Organization
Organization Name:SWEET TOOTH ORTHODONTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-239-0703
Mailing Address - Street 1:7381 W 133RD ST # 333
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4750
Mailing Address - Country:US
Mailing Address - Phone:913-239-0703
Mailing Address - Fax:
Practice Address - Street 1:7381 W 133RD ST # 333
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-4750
Practice Address - Country:US
Practice Address - Phone:913-239-0703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental