Provider Demographics
NPI:1093038630
Name:FRANCISCO, KENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:
Last Name:FRANCISCO
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 1:29820 BADEN PL
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-3845
Mailing Address - Country:US
Mailing Address - Phone:310-457-7205
Mailing Address - Fax:
Practice Address - Street 1:29820 BADEN PL
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-3845
Practice Address - Country:US
Practice Address - Phone:310-457-7205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30342122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist