MEDICARE: DR. MICHAEL CHRISTIAN RENO D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6973	KS

General Provider Information

NPI Number	:	1568431971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL CHRISTIAN RENO D.D.S.

Provider Business Mailing Address
First Line	:	2230 N RIDGE RD
Second Line	:	SUITE C
City	:	WICHITA
State	:	KS
Zip	:	67205-1053
Country	:	US
Telephone Number	:	316-722-6060
Fax Number	:	316-721-3277

Provider Business Practice Location Address
First Line	:	2230 N RIDGE RD
Second Line	:	SUITE C
City	:	WICHITA
State	:	KS
Zip	:	67205-1053
Country	:	US
Telephone Number	:	316-722-6060
Fax Number	:	316-721-3277

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. MICHAEL CHRISTIAN RENO D.D.S.” Practice Location

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