Provider Demographics
NPI:1588836183
Name:HAVARD, KENNETH SEELY (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:SEELY
Last Name:HAVARD
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 1:619 CROMWELL WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-4143
Mailing Address - Country:US
Mailing Address - Phone:512-818-0232
Mailing Address - Fax:
Practice Address - Street 1:4402 WILLIAMS DR
Practice Address - Street 2:SUITE 106
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-1341
Practice Address - Country:US
Practice Address - Phone:512-818-0232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX237591223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry