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Individual

DR. ALAN THIBAULT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S., P.A.

Contact information

Practice address
3900 W CENTRAL AVE, STE 100, WICHITA, KS 67203-4928
(316) 616-1310
Mailing address
4316 S HALSTEAD RD, HALSTEAD, KS 67056-9288

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
6292
KS

Other

Enumeration date
01/04/2006
Last updated
06/13/2008
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