Provider Demographics
NPI:1609048388
Name:SOAPES, KENNETH J (DMD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:J
Last Name:SOAPES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 PRATT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19124-1923
Mailing Address - Country:US
Mailing Address - Phone:215-535-5577
Mailing Address - Fax:215-535-6588
Practice Address - Street 1:1526 PRATT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-1923
Practice Address - Country:US
Practice Address - Phone:215-535-5577
Practice Address - Fax:215-535-6588
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022465L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist