Individual
NEAL BRADLEY WANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
120 STATE AVE N, KENT, WA 98030-4554
(253) 852-3929
Mailing address
120 STATE AVE N, KENT, WA 98030-4554
(253) 630-4542
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
251-030005883
WA
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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