Provider Demographics
NPI:1285823716
Name:DYER, KEVIN F (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:F
Last Name:DYER
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 1:1030 WOODED POND DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-4766
Mailing Address - Country:US
Mailing Address - Phone:917-334-2395
Mailing Address - Fax:
Practice Address - Street 1:9990 SUSQUEHANNA TRL S
Practice Address - Street 2:
Practice Address - City:GLEN ROCK
Practice Address - State:PA
Practice Address - Zip Code:17327-8493
Practice Address - Country:US
Practice Address - Phone:717-428-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0372761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice