Individual
KEVIN M. KNUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3009 E 92ND ST, CHICAGO, IL 60617-4502
(773) 978-1231
Mailing address
5138 LAKESHORE RD, FORT GRATIOT, MI 48059-3115
(810) 531-1193
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019029750
IL
Other
Enumeration date
03/26/2013
Last updated
10/01/2014
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