Provider Demographics
NPI:1477798965
Name:PLATNER, KEVIN EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:EUGENE
Last Name:PLATNER
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 1:1495 VICTOR AVE.
Mailing Address - Street 2:SUITE B
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-4093
Mailing Address - Country:US
Mailing Address - Phone:530-222-2237
Mailing Address - Fax:
Practice Address - Street 1:1495 VICTOR AVE.
Practice Address - Street 2:SUITE B
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-4093
Practice Address - Country:US
Practice Address - Phone:530-222-2237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36107122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist