Individual
KENT DEXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01532
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0665711
—
IA
01
—
55986
BLUE CROSS BLUE SHIELD
IA
01
—
I20282
MEDICARE
IA
Enumeration date
06/14/2007
Last updated
12/27/2007
Update your record
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