MEDICARE: KENNETH R. EYE II, DDS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	0401411947	VA

General Provider Information

NPI Number	:	1164812079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNETH R. EYE II, DDS, PLLC

Provider Business Mailing Address
First Line	:	563 UNIVERSITY BLVD
Second Line	:	SUITE 140
City	:	HARRISONBURG
State	:	VA
Zip	:	22801-3752
Country	:	US
Telephone Number	:	540-434-5500
Fax Number	:	540-434-5525

Provider Business Practice Location Address
First Line	:	563 UNIVERSITY BLVD
Second Line	:	SUITE 140
City	:	HARRISONBURG
State	:	VA
Zip	:	22801-3752
Country	:	US
Telephone Number	:	540-434-5500
Fax Number	:	540-434-5525

Authorized Official
Title or Position	:	DENTIST, OWNER
Name	:	DR. KENNETH ROBERT EYE II
Credential	:	DDS
Telephone Number	:	305-778-9889

Provider Enumeration Date	:	01/30/2015
Last Update Date	:	01/30/2015

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