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Individual

DR. KENYON MCGILL FORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
7135 DR. M. L. KING JR., STREET NORTH, ST. PETERSBURG, FL 33702
(727) 525-5455
(727) 525-7223
Mailing address
7135 DR. M. L. KING JR., STREET NORTH, ST. PETERSBURG, FL 33702
(727) 525-5455
(727) 525-7223

Taxonomy

Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
DN0012496
FL

Other

Enumeration date
10/03/2006
Last updated
07/08/2007
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