Provider Demographics
NPI:1982796363
Name:NASH, KENNETH CRAIG (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:CRAIG
Last Name:NASH
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 1:1550 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2611
Mailing Address - Country:US
Mailing Address - Phone:805-688-5557
Mailing Address - Fax:805-688-3503
Practice Address - Street 1:1550 ELM AVE
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2611
Practice Address - Country:US
Practice Address - Phone:805-688-5557
Practice Address - Fax:805-688-3503
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA357681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice