Provider Demographics
NPI:1154313583
Name:LESS, KEVIN DOUGLAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:DOUGLAS
Last Name:LESS
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 1:2021 GEER RD
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2405
Mailing Address - Country:US
Mailing Address - Phone:209-668-3636
Mailing Address - Fax:209-668-7526
Practice Address - Street 1:2021 GEER RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2405
Practice Address - Country:US
Practice Address - Phone:209-668-3636
Practice Address - Fax:209-668-7526
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA464041223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics