Provider Demographics
NPI:1457772832
Name:KEVIN F. KINGRY, DMD, P.C.
Entity Type:Organization
Organization Name:KEVIN F. KINGRY, DMD, P.C.
Other - Org Name:KINGRY FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:F
Authorized Official - Last Name:KINGRY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:334-712-1224
Mailing Address - Street 1:1290 WESTGATE PKWY
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2153
Mailing Address - Country:US
Mailing Address - Phone:334-712-1224
Mailing Address - Fax:334-712-0050
Practice Address - Street 1:1290 WESTGATE PKWY
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2153
Practice Address - Country:US
Practice Address - Phone:334-712-1224
Practice Address - Fax:334-712-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty