Provider Demographics
NPI:1164812079
Name:KENNETH R. EYE II, DDS, PLLC
Entity Type:Organization
Organization Name:KENNETH R. EYE II, DDS, PLLC
Other - Org Name:EXCEPTIONAL SMILES FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:EYE
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-778-9889
Mailing Address - Street 1:563 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3752
Mailing Address - Country:US
Mailing Address - Phone:540-434-5500
Mailing Address - Fax:540-434-5525
Practice Address - Street 1:563 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3752
Practice Address - Country:US
Practice Address - Phone:540-434-5500
Practice Address - Fax:540-434-5525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411947122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty