Provider Demographics
NPI:1891292322
Name:WINFIELD DENTAL, LLC
Entity Type:Organization
Organization Name:WINFIELD DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BULLEIGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-221-9580
Mailing Address - Street 1:107 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-2442
Mailing Address - Country:US
Mailing Address - Phone:620-221-9580
Mailing Address - Fax:620-221-6075
Practice Address - Street 1:107 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-2442
Practice Address - Country:US
Practice Address - Phone:620-221-9580
Practice Address - Fax:620-221-6075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental