Individual
THOMAS LEVIER GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
1246 E WALNUT LAWN ST, SPRINGFIELD, MO 65804-4202
(417) 719-7862
Mailing address
1246 E WALNUT LAWN ST, SPRINGFIELD, MO 65804-4202
(417) 719-7862
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2014021043
MO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
23133
FL
Other
Enumeration date
08/19/2014
Last updated
12/05/2024
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