# KM DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144975632
- **Authorized official:** DR. KEVIN THOMAS MASKELL DMD (OWNER)
- **Authorized official phone:** (520) 360-3012

## Contact information

- **Practice address:** 2471 N COUNTRY CLUB RD, TUCSON, AZ 85716-2503
- **Practice address phone:** (520) 327-5661
- **Practice address fax:** (520) 325-6557
- **Mailing address:** 5051 E CAMINO BOSQUE, TUCSON, AZ 85718-4613
- **Mailing address phone:** (520) 360-3012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/14/2022
- **Last updated:** 02/14/2022