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Individual

KEVIN JAMES DONLY

Active
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Individual

KEVIN JAMES DONLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15235
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120843104
—
TX
05
—
120843107
—
TX
05
—
120843108
—
TX
05
—
120843110
—
TX
01
—
15235
TEXAS DENTAL LICENSE
TX
01
—
84D665
BCBS
—
Enumeration date
06/25/2006
Last updated
07/18/2011
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