Provider Demographics
NPI:1922252907
Name:KEVIN KING, DDS
Entity Type:Organization
Organization Name:KEVIN KING, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:ADAMS
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-466-2499
Mailing Address - Street 1:101 W CASCADE WAY
Mailing Address - Street 2:SUITE #201
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-6016
Mailing Address - Country:US
Mailing Address - Phone:509-466-2499
Mailing Address - Fax:
Practice Address - Street 1:101 W CASCADE WAY
Practice Address - Street 2:SUITE #201
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6016
Practice Address - Country:US
Practice Address - Phone:509-466-2499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEVIN KING DDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA50831223G0001X
WA73581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty