Provider Demographics
NPI:1831394592
Name:MUELLER, KENT LANE (DDS)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:LANE
Last Name:MUELLER
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 1:1858 GUERNSEY AVE
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3818
Mailing Address - Country:US
Mailing Address - Phone:215-885-1515
Mailing Address - Fax:215-885-1516
Practice Address - Street 1:1858 GUERNSEY AVE
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3818
Practice Address - Country:US
Practice Address - Phone:215-885-1515
Practice Address - Fax:215-885-1516
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021630L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice