Healthcare Provider Details

I. General information

NPI: 1013094762
Provider Name (Legal Business Name): CYNTHIA LOUISE WREHE RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E 63RD STREET
KANSAS CITY MO
64113
US

IV. Provider business mailing address

101 E 63RD STREET
KANSAS CITY MO
64113
US

V. Phone/Fax

Practice location:
  • Phone: 816-333-1393
  • Fax: 816-361-6275
Mailing address:
  • Phone: 816-333-1393
  • Fax: 816-361-6275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number002381
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: