Provider Demographics
NPI:1578634671
Name:KEMP, KATHRYN MAULT (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:MAULT
Last Name:KEMP
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 S OTTERBEIN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2951
Mailing Address - Country:US
Mailing Address - Phone:614-882-7555
Mailing Address - Fax:614-882-0738
Practice Address - Street 1:509 S OTTERBEIN AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2951
Practice Address - Country:US
Practice Address - Phone:614-882-7555
Practice Address - Fax:614-882-0738
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH201061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice