Provider Demographics
NPI:1740341668
Name:KENNETH H. COVINGTON DDS
Entity type:Organization
Organization Name:KENNETH H. COVINGTON DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:HUGHES
Authorized Official - Last Name:COVINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PA
Authorized Official - Phone:479-253-7689
Mailing Address - Street 1:4052 E VAN BUREN
Mailing Address - Street 2:SUITE C
Mailing Address - City:EUREKA SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72632-9499
Mailing Address - Country:US
Mailing Address - Phone:479-253-7689
Mailing Address - Fax:479-253-5485
Practice Address - Street 1:4052 E VAN BUREN
Practice Address - Street 2:SUITE C
Practice Address - City:EUREKA SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72632-9499
Practice Address - Country:US
Practice Address - Phone:479-253-7689
Practice Address - Fax:479-253-5485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR25021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty