MEDICARE: DR. ANYA KENT D.D.S.

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	1223E0200X	Endodontics	049127	NY
2	1223E0200X	Endodontics	8827	SC

General Provider Information

NPI Number	:	1639259120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANYA KENT D.D.S.

Provider Business Mailing Address
First Line	:	1780 GREENSPOINT CT
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-8132
Country	:	US
Telephone Number	:	646-594-3020
Fax Number	:

Provider Business Practice Location Address
First Line	:	1780 GREENSPOINT CT
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466
Country	:	US
Telephone Number	:	646-594-3020
Fax Number	:	843-352-2430

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	06/16/2018

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