Individual
DR. MATTHEW E. KENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
520 N GREENWOOD STREET, SHOSHONE, ID 83352
(208) 537-2020
(208) 537-2010
Mailing address
520 N GREENWOOD STREET, SHOSHONE, ID 83352
(208) 537-2020
(208) 537-2010
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100083
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807212200
—
ID
Enumeration date
09/09/2005
Last updated
10/04/2016
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