Individual
DR. KENNETH MARK BUILDER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
123 SE DOUGLAS ST, NEWPORT, OR 97365-4426
(541) 265-4221
(541) 574-6552
Mailing address
PO BOX 1045, NEWPORT, OR 97365-0080
(541) 265-4221
(541) 574-6552
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7773
OR
Other
Enumeration date
11/09/2005
Last updated
07/08/2007
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