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General NPI Number Information
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NPI Number | 1598916058
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Entity Type | Individual
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Provider Name | KEVIN CHRISTOPHER KEAN DDS
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Gender | Male
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 03/15/2014
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Provider Practice Location Address
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Address Line | 12710 W IH 10 SUITE 120
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City | SAN ANTONIO
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State | TX
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Zip | 78230-1000
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Country | US
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Telephone | 210-836-9920
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Fax | 210-558-0925
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Provider Business Mailing Address
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Address Line | 8638 HUEBNER ROAD APT 5435
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City | SAN ANTONIO
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State | TX
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Zip | 78240
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Country | US
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Telephone | 714-797-5433
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 57739
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 24309
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License Number State | TX
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