Individual
KEVIN DRISCOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4389 BEAUFORT ROAD, HAVELOCK, NC 28532
(718) 689-0169
Mailing address
14 ALLEN CT, STATEN ISLAND, NY 10310-2703
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12633
CT
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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