Provider Demographics
NPI:1760543961
Name:PAKMAN, KENNETH S (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:S
Last Name:PAKMAN
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 1:444 N YORK RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2102
Mailing Address - Country:US
Mailing Address - Phone:215-675-4536
Mailing Address - Fax:215-675-5090
Practice Address - Street 1:444 N YORK RD
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-2102
Practice Address - Country:US
Practice Address - Phone:215-675-4536
Practice Address - Fax:215-675-5090
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO-19178-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice