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Individual

DR. TANNER GERARD ROBERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
650 E 25TH ST, KANSAS CITY, MO 64108-2716
(573) 837-9216
Mailing address
133 ROYAL OAK DR, CAPE GIRARDEAU, MO 63701-9242
(573) 837-9216

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2024019778
MO

Other

Enumeration date
06/18/2024
Last updated
06/18/2024
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