Provider Demographics
NPI:1598916058
Name:KEAN, KEVIN CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:CHRISTOPHER
Last Name:KEAN
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 1:8638 HUEBNER ROAD
Mailing Address - Street 2:APT 5435
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240
Mailing Address - Country:US
Mailing Address - Phone:714-797-5433
Mailing Address - Fax:
Practice Address - Street 1:12710 W IH 10
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1000
Practice Address - Country:US
Practice Address - Phone:210-836-9920
Practice Address - Fax:210-558-0925
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2014-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57739122300000X
TX24309122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist