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General NPI Number Information
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NPI Number | 1992119184
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Entity Type | Individual
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Provider Name | KEVIN JAMES BODILY D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | SPANGDAHLEM DENTAL CLINIC SPANGDAHLEM AB, GERMANY
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City | APO
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State | AE
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Zip | 09123
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Country | US
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Telephone | 314-452-3510
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Fax |
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Provider Business Mailing Address
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Address Line | 7321 BALMER ST BLDG 570
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City | HILL AFB
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State | UT
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Zip | 84056-5012
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Country | US
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Telephone | 801-777-7011
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D010255
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License Number State | AZ
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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 | 9052001-9926
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License Number State | UT
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