Organization
KEVIN A DELORIA DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN A DELORIA DDS (DENTIST)
(765) 342-8435
Entity
Organization
Contact information
Practice address
1690 S OHIO ST, MARTINSVILLE, IN 46151-3317
(765) 342-8435
(765) 342-3561
Mailing address
1690 S OHIO ST, MARTINSVILLE, IN 46151-3317
(765) 342-8435
(765) 342-3561
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009312
IN
Other
Enumeration date
05/27/2015
Last updated
05/27/2015
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