Provider Demographics
NPI:1942431580
Name:DEVERS, KRISTOPHER LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRISTOPHER
Middle Name:LEE
Last Name:DEVERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73-5618 MAIAU ST
Mailing Address - Street 2:SUITE B202
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:73-5618 MAIAU ST
Practice Address - Street 2:SUITE B202
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2616
Practice Address - Country:US
Practice Address - Phone:808-345-7577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-23881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice