Provider Demographics
NPI:1922268465
Name:KEVIN S. BONE, D.D.S., PLC
Entity Type:Organization
Organization Name:KEVIN S. BONE, D.D.S., PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BONE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-799-8717
Mailing Address - Street 1:4170 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-4025
Mailing Address - Country:US
Mailing Address - Phone:989-792-7461
Mailing Address - Fax:989-792-8857
Practice Address - Street 1:4170 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-4025
Practice Address - Country:US
Practice Address - Phone:989-792-7461
Practice Address - Fax:989-792-8857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1469401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty