Individual
KEVIN SCOTT KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1212 HORTON ST, LA CROSSE, WI 54601-6372
(608) 788-1090
Mailing address
423 FLINT CT., ONALASKA, WI 54650
(608) 779-1503
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2496
WI
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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