Provider Demographics
NPI:1902808066
Name:LINNEMAN, TERRY CHARLES (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:CHARLES
Last Name:LINNEMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7515 NALL AVE
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-4762
Mailing Address - Country:US
Mailing Address - Phone:913-649-5933
Mailing Address - Fax:913-649-8275
Practice Address - Street 1:7515 NALL AVE
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-4762
Practice Address - Country:US
Practice Address - Phone:913-649-5933
Practice Address - Fax:913-649-8275
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS52151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice