Individual
DR. TERRY LAYNE TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
200 W LOCUST ST, UNION, MO 63084-1751
(636) 583-4292
Mailing address
200 W LOCUST ST, UNION, MO 63084-1751
(636) 583-4292
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14565
MO
Other
Enumeration date
11/04/2007
Last updated
11/04/2007
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