Organization
KEVIN C. DEAN, DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI BROCK MBA (MANAGER)
(850) 477-1125
Entity
Organization
Contact information
Practice address
4850 N 9TH AVE STE 4, PENSACOLA, FL 32503-2406
(850) 477-1125
(850) 479-5809
Mailing address
4850 N 9TH AVE STE 4, PENSACOLA, FL 32503-2406
(850) 477-1125
(850) 479-5809
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN12675
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0716316-00
—
FL
Enumeration date
11/15/2011
Last updated
11/15/2011
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