Provider Demographics
NPI:1801990080
Name:DETMER, MARGARET ANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:MARGARET ANNE
Middle Name:
Last Name:DETMER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8404 W 13TH ST N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-2978
Mailing Address - Country:US
Mailing Address - Phone:316-721-8100
Mailing Address - Fax:316-721-8707
Practice Address - Street 1:8404 W 13TH ST N
Practice Address - Street 2:SUITE 200
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2978
Practice Address - Country:US
Practice Address - Phone:316-721-8100
Practice Address - Fax:316-721-8707
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6490208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice