MEDICARE: DR. KEVIN FRANK KINGRY D.M.D.

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
1	1223G0001X	General Practice Dentistry	5183	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326134271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN FRANK KINGRY D.M.D.

Provider Business Mailing Address
First Line	:	16 ARCADE UNIT 198747
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37219-1994
Country	:	US
Telephone Number	:	615-750-0343
Fax Number	:

Provider Business Practice Location Address
First Line	:	5412 MONTGOMERY HWY
Second Line	:	SUITE 8
City	:	DOTHAN
State	:	AL
Zip	:	36303-1657
Country	:	US
Telephone Number	:	334-983-1730
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	06/25/2013

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Directions to “ DR. KEVIN FRANK KINGRY D.M.D.” Practice Location

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