Provider Demographics
NPI:1477902567
Name:KAY, TREVOR (DDS)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:KAY
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 1:2017 N WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-4269
Mailing Address - Country:US
Mailing Address - Phone:586-817-0367
Mailing Address - Fax:
Practice Address - Street 1:6668 BERNIE KOHLER DR
Practice Address - Street 2:
Practice Address - City:NORTH BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48461-8885
Practice Address - Country:US
Practice Address - Phone:810-688-3047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist