Organization
DR KENNETH R LEVINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH R LEVINE DDS (DOCTOR)
(954) 722-1100
Entity
Organization
Contact information
Practice address
8333 W MCNAB RD STE 104, TAMARAC, FL 33321-3203
(954) 722-1100
(954) 722-1434
Mailing address
8333 W MCNAB RD STE 104, TAMARAC, FL 33321-3203
(954) 722-1100
(954) 722-1434
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN6044
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85330
BCBS
FL
Enumeration date
04/11/2007
Last updated
02/07/2012
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