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Individual
MR. KEVIN MICHAEL SKINNER
Active
Individual
MR. KEVIN MICHAEL SKINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D401410055
VA
1223G0001X
General Practice Dentistry
0401410055
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401410055
VIRGINIA STATE LICENSE
VA
Enumeration date
02/09/2007
Last updated
08/12/2020
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