Individual
DR. KEVIN LEON MENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
7930 FROST ST STE 101, SAN DIEGO, CA 92123-2756
(858) 492-9977
Mailing address
7930 FROST ST STE 101, SAN DIEGO, CA 92123-2756
(858) 492-9977
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30222
TX
122300000X
Dentist
D010279
AZ
122300000X
Dentist
DDS104865
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
30222
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
D010279
AZ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DDS104865
CA
Other
Enumeration date
07/17/2014
Last updated
06/30/2020
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