# KENNETH R DIBBLE DDS

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

## Provider details

- **NPI number:** 1891434445
- **Authorized official:** KENNETH REID DIBBLE DDS (OWNER/PRESIDENT)
- **Authorized official phone:** (801) 232-7022

## Contact information

- **Practice address:** 1509 NORTHWEST HWY, GARLAND, TX 75041-5231
- **Practice address phone:** (972) 840-6100
- **Mailing address:** 908 E RIPARIAN DR, DRAPER, UT 84020-8541
- **Mailing address phone:** (801) 232-7022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/01/2022
- **Last updated:** 06/01/2022