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NPI Code Detail

MEDICARE: KEVIN DREESEN

MEDICARE:   KEVIN  DREESEN
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
11223G0001XGeneral Practice Dentistry7754OK

General Provider Information

NPI Number : 1942992995
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN DREESEN
Provider Business Mailing Address
First Line : 400 RIVERWALK TER
Second Line :
City : JENKS
State : OK
Zip : 74037-5606
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6616 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73139-1708
Country : US
Telephone Number : 405-601-7852
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2023
Last Update Date : 05/25/2023

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Directions to “ KEVIN DREESEN ” Practice Location

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