Provider Demographics
NPI:1740486612
Name:KEMMET, LINDELL C (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDELL
Middle Name:C
Last Name:KEMMET
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 1:1015 S BROADWAY
Mailing Address - Street 2:SUITE 24
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-4667
Mailing Address - Country:US
Mailing Address - Phone:701-852-4789
Mailing Address - Fax:701-852-7273
Practice Address - Street 1:1015 S BROADWAY
Practice Address - Street 2:SUITE 24
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4667
Practice Address - Country:US
Practice Address - Phone:701-852-4789
Practice Address - Fax:701-852-7273
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND21251223G0001X, 1223G0001X
MND12881122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist