Provider Demographics
NPI:1083680623
Name:KEMP, DAVID BARRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BARRY
Last Name:KEMP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4918 TERRI ANN CIR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-4170
Mailing Address - Country:US
Mailing Address - Phone:325-698-6821
Mailing Address - Fax:
Practice Address - Street 1:697 LOUISIANA DRIVE
Practice Address - Street 2:DYESS AIR FORCE BASE
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79607-1367
Practice Address - Country:US
Practice Address - Phone:325-696-2304
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX139031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice