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Individual
KENNETH E BEAN
Active
Individual
KENNETH E BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5513
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100224750C
—
KS
01
—
1055673
DORAL
KS
Enumeration date
02/26/2006
Last updated
03/13/2009
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