Provider Demographics
NPI:1407207285
Name:GAILEY, KEVIN Q
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:Q
Last Name:GAILEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 JARRETT WHITE ROAD, MCDS-NH
Mailing Address - Street 2:US ARMY DENTAL ACTIVITY HAWAII
Mailing Address - City:TRIPLER AMC
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5000
Mailing Address - Country:US
Mailing Address - Phone:808-438-4131
Mailing Address - Fax:
Practice Address - Street 1:1 JARRETT WHITE ROAD, MCDS-NH
Practice Address - Street 2:US ARMY DENTAL ACTIVITY HAWAII
Practice Address - City:TRIPLER AMC
Practice Address - State:HI
Practice Address - Zip Code:96859-5000
Practice Address - Country:US
Practice Address - Phone:808-438-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant