Provider Demographics
NPI:1881647287
Name:KAYS, KEVIN E (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:E
Last Name:KAYS
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 1:205 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62946-1256
Mailing Address - Country:US
Mailing Address - Phone:618-998-0820
Mailing Address - Fax:
Practice Address - Street 1:11806 KHOURY LEAGUE RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-7739
Practice Address - Country:US
Practice Address - Phone:618-998-0820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-15730122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist