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General NPI Number Information
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NPI Number | 1861719254
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Entity Type | Individual
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Provider Name | KEVIN DUANE RASMUSSEN DDS
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Gender | Male
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 1380 S PATRICK DR
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City | PATRICK AFB
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State | FL
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Zip | 32925-3621
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Country | US
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Telephone | 321-494-2184
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Fax |
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Provider Business Mailing Address
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Address Line | 1380 S PATRICK DR
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City | PATRICK AFB
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State | FL
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Zip | 32925-3621
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Country | US
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Telephone | 321-494-2184
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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 | DD3621
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DD3621
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN30081
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License Number State | FL
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