Provider Demographics
NPI:1891186672
Name:KEMON, ANN (RDH)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:KEMON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 LYME RD STE 3
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-1207
Mailing Address - Country:US
Mailing Address - Phone:603-643-3509
Mailing Address - Fax:
Practice Address - Street 1:73 LYME RD STE 3
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1207
Practice Address - Country:US
Practice Address - Phone:603-643-3509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-14
Last Update Date:2015-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH791124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist