Provider Demographics
NPI:1770208621
Name:FIRST DENTAL GARDEN CITY, LLC
Entity type:Organization
Organization Name:FIRST DENTAL GARDEN CITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LEHMKUHLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:620-277-9330
Mailing Address - Street 1:1502 HARDING AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-4700
Mailing Address - Country:US
Mailing Address - Phone:620-277-9330
Mailing Address - Fax:620-277-9270
Practice Address - Street 1:1502 HARDING AVE STE 9
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-4700
Practice Address - Country:US
Practice Address - Phone:620-277-9330
Practice Address - Fax:620-277-9270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental