Bolin, Kenneth Anthony
Bolin, Kenneth Anthony is an sole proprietor health care provider with primary practice located at 14335 Regency Pl , Dallas TX 75254-8509. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Bolin, Kenneth Anthony can be contacted via phone (972) 716-9787.Contact Information
Primary practice address
14335 Regency Pl
Dallas TX 75254-8509
Phone: (972) 716-9787
Fax: (972) 716-9787
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 12794 | Texas |
Profile Details
| NPI number | 1255334140 |
|---|---|
| LBN Legal business name | Bolin, Kenneth Anthony |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 24th, 2005 |
| Last updated | Aug 12th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255334140 | NPPES |
| Texas | MEDICAID | 1267114-02 |
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