Healthcare Provider Details

I. General information

NPI: 1083680623
Provider Name (Legal Business Name): DAVID BARRY KEMP D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

697 LOUISIANA DRIVE DYESS AIR FORCE BASE
ABILENE TX
79607-1367
US

IV. Provider business mailing address

4918 TERRI ANN CIR
ABILENE TX
79606-4170
US

V. Phone/Fax

Practice location:
  • Phone: 325-696-2304
  • Fax:
Mailing address:
  • Phone: 325-698-6821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13903
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: