Provider Demographics
NPI:1558448506
Name:FLOYD, KEVIN CURTISS (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:CURTISS
Last Name:FLOYD
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 1:1100 RICKARD RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-6301
Mailing Address - Country:US
Mailing Address - Phone:217-546-6775
Mailing Address - Fax:
Practice Address - Street 1:1100 RICKARD RD
Practice Address - Street 2:SUITE A
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-6301
Practice Address - Country:US
Practice Address - Phone:217-546-6775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist