Individual
DR. KENNETH ALEXANDER POOLE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2835 HORSE PEN CREEK RD STE 106, GREENSBORO, NC 27410-9700
(336) 662-0807
(336) 662-0828
Mailing address
4020 DUPLIN DR, GREENSBORO, NC 27407-7763
(336) 315-0943
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6081
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40706
BCBS OF TENN.
TN
01
—
810-41
BCBS OF ALABAMA
AL
01
—
864646
PENN. BLUE SHIELD
PA
05
—
8996986
—
NC
01
—
96986
BCBS PROVIDER #
NC
01
—
V0068
BCBS OF TEXAS
TX
Enumeration date
07/07/2006
Last updated
07/09/2007
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