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NPI Code Detail

MEDICARE: JOSEPH M KENT DDS INC.

MEDICARE: JOSEPH M KENT DDS INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1B25919OTHERCADENTAL LIC

General Provider Information

NPI Number : 1184040610
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSEPH M KENT DDS INC.
Provider Business Mailing Address
First Line : P.O. BOX 186
Second Line :
City : LAKE ISABELLA
State : CA
Zip : 93240
Country : US
Telephone Number : 760-379-3625
Fax Number : 760-230-9165
Provider Business Practice Location Address
First Line : 6421 LYNCH CANYON DRIVE
Second Line :
City : LAKE ISABELLA
State : CA
Zip : 93240
Country : US
Telephone Number : 760-379-3625
Fax Number : 760-230-9165
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOSEPH MAUGHAN KENT
Credential : D.D.S.
Telephone Number : 760-379-3625
Provider Enumeration Date : 03/07/2014
Last Update Date : 11/08/2019

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