Individual
KEVIN M ALLRED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
407 3RD AVE E, BIG STONE GAP, VA 24219-2365
(276) 523-0931
Mailing address
PO BOX 84, KAYSVILLE, UT 84037-0084
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401413594
VA
Other
Enumeration date
05/31/2012
Last updated
05/31/2012
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