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NPI 1568637064

NPI 1568637064 : KEVIN G. LANDON, DDS, INC. : MONTEREY, CA

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General NPI Number Information
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    NPI Number           |    1568637064
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    Entity Type          |    Organization 
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    Legal Business Name  |    KEVIN G. LANDON, DDS, INC. 
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Dates
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    Enumeration Date     |    04/25/2008
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    Last Update Date     |    09/22/2014
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Provider Practice Location Address
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    Address Line         |    333 EL DORADO ST 
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    City                 |    MONTEREY
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    State                |    CA
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    Zip                  |    93940-4606
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    Country              |    US
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    Telephone            |    831-375-4014
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    333 EL DORADO ST 
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    City                 |    MONTEREY
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    State                |    CA
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    Zip                  |    93940-4606
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DENTIST
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    Name                 |    DR. KEVIN G. LANDON 
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    Credential           |    DDS
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    Telephone            |    831-375-4014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QD0000X
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    Taxonomy Name        |    Dental Clinic/Center
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    License Number       |    24311
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    License Number State |    CA
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