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General NPI Number Information
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NPI Number | 1215965199
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Entity Type | Individual
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Provider Name | DAVID A KENT M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 5561 N GLENWOOD ST STE B
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City | GARDEN CITY
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State | ID
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Zip | 83714-1336
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Country | US
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Telephone | 208-863-0860
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Fax | 208-954-5595
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Provider Business Mailing Address
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Address Line | 2375 S COBALT POINT WAY STE 102
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City | MERIDIAN
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State | ID
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Zip | 83642-8029
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Country | US
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Telephone | 208-863-0860
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Fax | 208-954-5595
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | M5609
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License Number State | ID
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