Healthcare Provider Details

I. General information

NPI: 1659964674
Provider Name (Legal Business Name): TREVOR KAY DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2021
Last Update Date: 02/20/2021
Certification Date: 02/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 M 137
INTERLOCHEN MI
49643-9386
US

IV. Provider business mailing address

8892 SUNSET W
TRAVERSE CITY MI
49686-1513
US

V. Phone/Fax

Practice location:
  • Phone: 231-276-9051
  • Fax:
Mailing address:
  • Phone: 586-817-0367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TREVOR KAY
Title or Position: OWNER
Credential: DDS
Phone: 586-817-0367