Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0700X | Prosthodontist | 019.26023 | IL |
N | 1223P0700X | Prosthodontist | 046793-1 | NY |
Y | 1223P0700X | Prosthodontist | 40172 | IA |
N | 1223P0700X | Prosthodontist | 58605 | CA |
NPI | 1215100144 |
---|---|
Provider Name | Kevin C Tseng |
First Address | Iowa City, IA 52242-1001 |
Second Address | Iowa City, IA 52242-1001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 11/04/2017 |