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General NPI Number Information
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NPI Number | 1720175946
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Entity Type | Organization
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Legal Business Name | KEVIN Y. MYINT, DDS
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 07/31/2012
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Provider Practice Location Address
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Address Line | 121 BIG ELK MALL
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City | ELKTON
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State | MD
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Zip | 21921-5912
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Country | US
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Telephone | 410-398-9500
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Fax | 410-398-0427
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Provider Business Mailing Address
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Address Line | 2939 AIRDRIE AVE
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City | ABINGDON
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State | MD
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Zip | 21009-2422
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Country | US
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Telephone | 410-569-0918
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Fax | 410-398-0427
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEVIN Y MYINT
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Credential | D.D.S.
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Telephone | 410-398-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 12461
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License Number State | MD
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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 | 12530
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License Number State | MD
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