Individual
DR. TANNER D BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2981 N. WEBB RD., WICHITA, KS 67226
(316) 685-2731
(316) 685-6946
Mailing address
2981 N. WEBB RD., WICHITA, KS 67226
(316) 685-2731
(316) 685-6946
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
61221
KS
1223P0300X
Periodontics
Primary
61221
KS
Other
Enumeration date
06/21/2016
Last updated
04/14/2020
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