Provider Demographics
NPI:1477626406
Name:LAYTON, KEVIN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:L
Last Name:LAYTON
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 1:5804 NW EXPRESSWAY ST
Mailing Address - Street 2:
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73132-5239
Mailing Address - Country:US
Mailing Address - Phone:405-728-3300
Mailing Address - Fax:405-728-5037
Practice Address - Street 1:5804 NW EXPRESSWAY ST
Practice Address - Street 2:
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73132-5239
Practice Address - Country:US
Practice Address - Phone:405-728-3300
Practice Address - Fax:405-728-5037
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK49331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice