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General NPI Number Information
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NPI Number | 1902593205
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Entity Type | Organization
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Legal Business Name | KEVIN L GOLDEN DMD PLLC
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 5965 THUNDER RD STE C
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City | CONCORD
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State | NC
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Zip | 28027
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Country | US
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Telephone | 704-610-8444
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Fax |
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Provider Business Mailing Address
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Address Line | 5965 THUNDER RD STE C
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City | CONCORD
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State | NC
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Zip | 28027
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Country | US
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Telephone | 704-610-8444
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | KEVIN L GOLDEN
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Credential | DMD
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Telephone | 770-689-8150
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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