Provider Demographics
NPI:1033567896
Name:MAR, BRENDEN CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRENDEN
Middle Name:CHRISTOPHER
Last Name:MAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 N WATERFRONT PKWY
Mailing Address - Street 2:BLDG. 400
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-6614
Mailing Address - Country:US
Mailing Address - Phone:316-687-2100
Mailing Address - Fax:316-687-1024
Practice Address - Street 1:1700 N WATERFRONT PKWY
Practice Address - Street 2:BLDG. 400
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-6614
Practice Address - Country:US
Practice Address - Phone:316-687-2100
Practice Address - Fax:316-687-1024
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS611491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice