Provider Demographics
NPI:1710005947
Name:EMBLER, KENNETH BERNARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:BERNARD
Last Name:EMBLER
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 1:1897 PALM BEACH LAKES BLVD
Mailing Address - Street 2:SUITE #106
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3507
Mailing Address - Country:US
Mailing Address - Phone:561-683-0700
Mailing Address - Fax:
Practice Address - Street 1:1897 PALM BEACH LAKES BLVD
Practice Address - Street 2:SUITE #106
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3507
Practice Address - Country:US
Practice Address - Phone:561-683-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL000067821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice