Healthcare Provider Details

I. General information

NPI: 1457344830
Provider Name (Legal Business Name): HOLLY D KENT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 E HARVARD AVE #320
DENVER CO
80210
US

IV. Provider business mailing address

950 E HARVARD AVE #320
DENVER CO
80210
US

V. Phone/Fax

Practice location:
  • Phone: 303-777-5006
  • Fax: 303-777-5079
Mailing address:
  • Phone: 303-777-5006
  • Fax: 303-777-5079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number30754
License Number StateCO

VIII. Authorized Official

Name: DR. HOLLY D KENT
Title or Position: PRESIDENT
Credential: MD
Phone: 303-777-5006