Kenneth C Woods, DMD

Individual provider Active NPI Dentist · New Wilmington, PA

NPI 1629165261 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1629165261
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
DS026268L (PA)
Practice address
212 W Vine Street
New Wilmington, PA 16142
Phone
(724) 946-3534
Fax
(724) 946-2144
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS026268LPAMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS026268L PA Yes

Addresses

Primary practice location

212 W Vine Street
New Wilmington, PA 16142

Mailing address

212 W Vine Street
New Wilmington, PA 16142
Phone (724) 946-3534

Other providers in New Wilmington, PA

All providers in New Wilmington, PA · Dentist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.