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Individual
KODY QUENTIN OSBORNE
Active
Individual
KODY QUENTIN OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D11460
OR
1223G0001X
General Practice Dentistry
Primary
D5324
ID
1223G0001X
General Practice Dentistry
DEN-DEN-LIC-21478
MT
Other
Enumeration date
06/27/2021
Last updated
10/27/2021
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