Provider Demographics
NPI:1093738841
Name:RAMSEY, KENNETH LAWRENCE
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:LAWRENCE
Last Name:RAMSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:KENNETH
Other - Middle Name:LAWRENCE
Other - Last Name:RAMSEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:405 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-4019
Mailing Address - Country:US
Mailing Address - Phone:662-338-9194
Mailing Address - Fax:
Practice Address - Street 1:405 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-4019
Practice Address - Country:US
Practice Address - Phone:662-338-9194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1412701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice