Provider Demographics
NPI:1154334571
Name:WESTBROOK, KENNETH LEIGH (DDS)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:LEIGH
Last Name:WESTBROOK
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 1:3708 SYMI CIR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4309
Mailing Address - Country:US
Mailing Address - Phone:252-726-5778
Mailing Address - Fax:252-726-2684
Practice Address - Street 1:3708 SYMI CIR
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4309
Practice Address - Country:US
Practice Address - Phone:252-726-5778
Practice Address - Fax:252-726-2684
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC76661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice