| Andre Thibault, Dds, Pa | |
|
3900 W Central Ave Suite 100 Wichita KS 67203-4928 | |
| (316) 616-1310 | |
| Not Available |
| Full Name | Andre Thibault, Dds, Pa |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 3900 W Central Ave, Wichita, Kansas |
| Authorized Official Name and Position | Andre Alan Thibault (OWNER) |
| Authorized Official Contact | 3166161310 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Andre Thibault, Dds, Pa 3900 W Central Ave Suite 100 Wichita KS 67203-4928 Ph: (316) 616-1310 | Andre Thibault, Dds, Pa 3900 W Central Ave Suite 100 Wichita KS 67203-4928 Ph: (316) 616-1310 |
| NPI Number | 1013203728 |
|---|---|
| Provider Enumeration Date | 06/21/2011 |
| Last Update Date | 06/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013203728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 6292 (Kansas) | Primary |
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