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General NPI Number Information
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NPI Number | 1962690586
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Entity Type | Organization
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Legal Business Name | WARREN R. RENSNER, D.D.S., PA.
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 404 S EDGEMOOR ST #320
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City | WICHITA
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State | KS
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Zip | 67218-1631
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Country | US
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Telephone | 316-683-6732
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Fax |
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Provider Business Mailing Address
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Address Line | 404 S EDGEMOOR ST #320
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City | WICHITA
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State | KS
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Zip | 67218-1631
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Country | US
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Telephone | 316-683-6732
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | WARREN RENSNER
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Credential |
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Telephone | 316-683-6732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5851
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License Number State | KS
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