Provider Demographics
NPI:1245492990
Name:DARNALL, THOMAS MCCLELLAN (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MCCLELLAN
Last Name:DARNALL
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 1:1911 W 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66103-3306
Mailing Address - Country:US
Mailing Address - Phone:913-221-4013
Mailing Address - Fax:
Practice Address - Street 1:3907 S CRACKERNECK RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-3924
Practice Address - Country:US
Practice Address - Phone:816-373-3101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60503122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist