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General NPI Number Information
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NPI Number | 1033567896
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Entity Type | Individual
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Provider Name | BRENDEN CHRISTOPHER MAR D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2016
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 1700 N WATERFRONT PKWY BLDG. 400
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City | WICHITA
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State | KS
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Zip | 67206-6614
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Country | US
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Telephone | 316-687-2100
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Fax | 316-687-1024
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Provider Business Mailing Address
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Address Line | 1700 N WATERFRONT PKWY BLDG. 400
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City | WICHITA
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State | KS
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Zip | 67206-6614
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Country | US
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Telephone | 316-687-2100
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Fax | 316-687-1024
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 61149
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License Number State | KS
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