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General NPI Number Information
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NPI Number | 1871991414
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Entity Type | Organization
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Legal Business Name | MONTEREY DENTAL CONTOURS RICHARD E. KENT DENTAL GROUP, INC
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Dates
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Enumeration Date | 12/14/2014
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Last Update Date | 12/14/2014
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Provider Practice Location Address
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Address Line | 2100 GARDEN RD SUITE K
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City | MONTEREY
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State | CA
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Zip | 93940-5366
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Country | US
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Telephone | 831-375-4242
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Fax | 831-375-4281
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Provider Business Mailing Address
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Address Line | 2100 GARDEN RD SUITE K
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City | MONTEREY
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State | CA
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Zip | 93940-5366
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Country | US
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Telephone | 831-375-4242
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Fax | 831-375-4281
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD EDWIN KENT
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Credential | DDS
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Telephone | 831-375-4242
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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 | 28871
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License Number State | CA
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