# MICHAEL M TANNER, DDS, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497929004
- **Authorized official:** CYNTHIA ELLIOTT DDS (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (913) 722-0610

## Contact information

- **Practice address:** 10400 W 103RD ST, SUITE 21, OVERLAND PARK, KS 66214-2640
- **Practice address phone:** (913) 722-0610
- **Practice address fax:** (913) 722-2893
- **Mailing address:** 10400 W 103RD ST, SUITE 21, OVERLAND PARK, KS 66214-2640
- **Mailing address phone:** (913) 722-0610
- **Mailing address fax:** (913) 722-2893

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6035 | KS | Yes |

## Other

- **Enumeration date:** 04/15/2008
- **Last updated:** 04/15/2008