Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 46404 | CA |
NPI | 1154313583 |
---|---|
Provider Name | Dr. Kevin Douglas Less |
First Address | Turlock, CA 95382-2405 |
Second Address | Turlock, CA 95382-2405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 02/05/2011 |