Provider Demographics
NPI:1649801481
Name:DENTON, KENT JR
Entity type:Individual
Prefix:
First Name:KENT
Middle Name:
Last Name:DENTON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 PROFESSIONAL CIR STE 3
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4374
Mailing Address - Country:US
Mailing Address - Phone:252-222-4327
Mailing Address - Fax:
Practice Address - Street 1:229 PROFESSIONAL CIR STE 3
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4374
Practice Address - Country:US
Practice Address - Phone:252-222-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1358237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty