Andre Thibault, Dds, PA

NPI #1013203728 in Wichita, Kansas

Provider Information

NPI Number: 1013203728
Entity Type: Organization
Organization Name: Andre Thibault, Dds, PA
Primary Specialty: Dentist - Endodontics
Enumeration Date: Jun 21, 2011
Last Updated: Jun 21, 2011

Practice Location

Address: 3900 W CENTRAL AVE
Address 2: SUITE 100
City: Wichita
State: Kansas
ZIP Code: 67203-4928
Phone: (316) 616-1310

Authorized Official

Name: DR. ANDRE ALAN THIBAULT, DDS
Title: OWNER
Phone: (316) 616-1310

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Endodontics — Endodontics	1223E0200X	Primary

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