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General NPI Number Information
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NPI Number | 1629299383
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Entity Type | Individual
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Provider Name | THOMAS H WRENN III DDS
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 12/18/2014
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Provider Practice Location Address
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Address Line | 1115 E 65TH ST
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City | KANSAS CITY
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State | MO
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Zip | 64131-1202
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Country | US
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Telephone | 816-444-9091
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Fax | 816-523-2263
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Provider Business Mailing Address
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Address Line | 1115 E 65TH ST SUITE 3
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City | KANSAS CITY
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State | MO
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Zip | 64131-1202
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Country | US
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Telephone | 816-444-9091
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Fax | 816-523-2263
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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 | 10872
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License Number State | MO
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