Individual
JOSEPH PORTER KINCHELOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2501 CAPEHART RD, OFFUTT AFB, NE 68113-1043
(209) 900-3221
Mailing address
10188 BIRCH BLUFF LN, LAS VEGAS, NV 89145-8822
(209) 900-3221
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11285975-9926
UT
Other
Enumeration date
04/07/2025
Last updated
07/28/2025
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