Provider Demographics
NPI:1790911022
Name:KRISTON J KENT MD PA
Entity Type:Organization
Organization Name:KRISTON J KENT MD PA
Other - Org Name:NAPLES FACIAL PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTON
Authorized Official - Middle Name:J
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-514-7888
Mailing Address - Street 1:1660 MEDICAL BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1415
Mailing Address - Country:US
Mailing Address - Phone:239-514-7888
Mailing Address - Fax:
Practice Address - Street 1:1660 MEDICAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1415
Practice Address - Country:US
Practice Address - Phone:239-514-7888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and NeckGroup - Single Specialty