Provider Demographics
NPI:1336863984
Name:WSD
Entity Type:Organization
Organization Name:WSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROSEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-687-5353
Mailing Address - Street 1:11150 S PFLUMM RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66215-4810
Mailing Address - Country:US
Mailing Address - Phone:913-782-0674
Mailing Address - Fax:
Practice Address - Street 1:11150 S PFLUMM RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66215-4810
Practice Address - Country:US
Practice Address - Phone:913-782-0674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental