Individual
DR. KEVIN DEAN FEDAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5330 CORPORATE CENTER LOOP SE STE B, LACEY, WA 98503-5558
(360) 456-5151
(360) 456-0525
Mailing address
5330 CORPORATE CENTER LOOP SE STE B, LACEY, WA 98503-5558
(360) 456-5151
(360) 456-0525
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7514
WA
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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