Individual
DR. KENNETH JAMES BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1100 WILFORD HALL LOOP, BLDG 4554, ATTN: 59 MDW/SGHC, SAN ANTONIO, TX 78236
(210) 292-6246
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(210) 565-0646
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
4531
LA
Other
Enumeration date
09/30/2005
Last updated
01/22/2021
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