Individual
DR. KEVIN E AMUNDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D8238
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011095
DORAL
MN
01
—
1008932
PREFERRED ONE
MN
01
—
117898
UCARE
MN
01
—
35012AM
BCBS
MN
Enumeration date
06/29/2006
Last updated
07/08/2007
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