Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 228402 | MA |
NPI | 1407992480 |
---|---|
Provider Name | David M Kent |
First Address | Troy, MI 48084-5251 |
Second Address | Troy, MI 48084-5251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 08/07/2007 |