Provider Demographics
NPI:1164640694
Name:AUMAN, KENNETH GLENN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:GLENN
Last Name:AUMAN
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 1:242 N TALBERT BLVD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-4143
Mailing Address - Country:US
Mailing Address - Phone:336-249-2908
Mailing Address - Fax:336-248-6468
Practice Address - Street 1:242 N TALBERT BLVD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-4143
Practice Address - Country:US
Practice Address - Phone:336-249-2908
Practice Address - Fax:336-248-6468
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC 5260122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist