# KDP PLLC

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

## Provider details

- **NPI number:** 1699331421
- **Authorized official:** RAJIV BERY DMD (DENTIST)
- **Authorized official phone:** (803) 464-4448

## Contact information

- **Practice address:** 1212 N KENTUCKY ST, KINGSTON, TN 37763-2328
- **Practice address phone:** (865) 717-3586
- **Mailing address:** 11600 LANESBOROUGH WAY APT 116, FARRAGUT, TN 37934-1691

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2019
- **Last updated:** 05/16/2019