Individual
DR. JOHN P TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MD
Contact information
Practice address
4700 BELLEVIEW, STE L 10, KANSAS CITY, MO 64112-1360
(816) 561-1115
(816) 931-7912
Mailing address
PO BOX 802752, KANSAS CITY, MO 64180-0001
(816) 561-1115
(816) 753-4493
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DEO15216-DENTAL
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16670147
BCBS OF KCMO
MO
Enumeration date
08/09/2006
Last updated
07/08/2007
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