Individual
DR. TRAVIS TANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2860 S SENECA ST, WICHITA, KS 67217-2865
(316) 522-4759
Mailing address
2860 S SENECA ST, SUITE C, WICHITA, KS 67217-2865
(316) 522-4759
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
61205
KS
Other
Enumeration date
06/13/2016
Last updated
08/15/2016
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