NPI 1013203728

Andre Thibault, DDS, PA

Organisation Endodontics Wichita, KS

Practice location

Address: 3900 W Central Ave Suite 100, Wichita, KS 67203-4928
Phone: (316) 616-1310

Authorised official

Name: Andre Alan Thibault
Title: Owner
Phone: (316) 616-1310

Registered specialties

Endodontics Primary

Dental Providers Taxonomy 1223E0200X Licence 6292 (KS)

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Registry record

NPI: 1013203728
Entity type: Organization
NPI issued: 21 Jun 2011
Record last updated: 21 Jun 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.