Kevin Clyde Potter in Eau Claire - Dentist
Kevin Clyde Potter - NPI 1891751582
Kevin Clyde Potter is a Dentist in Eau Claire, Wisconsin. Kevin Clyde Potter practices all healthcare services and medical treatments related to Dentist. The NPI Number for Kevin Clyde Potter is 1891751582. The last update date is 2007-07-08.
Kevin Clyde Potter's current location address is 1804 Warden St, Eau Claire, Wisconsin. You can contact this provider via phone number 7158348484. The mailing address for Kevin Clyde Potter is 1804 Warden St, Eau Claire, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin Clyde Potter |
|---|---|
| Address | 1804 Warden St, Eau Claire, Wisconsin |
| Phone Number | 7158348484 |
| Fax Number | |
| Sole Proprietor | X |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1891751582 |
|---|---|
| Provider Enumeration Date | 2006-04-22 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1804 Warden St |
|---|---|
| City | Eau Claire |
| State | Wisconsin (WI) |
| Post Code | 54703 |
| Phone Number | 7158348484 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 3070015 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 33447500 | WI | -- |
Post Comment/ Review Below
What is the Kevin Clyde Potter's unique identification number?
The Kevin Clyde Potter has been assigned the NPI (National Provider Identifier) Number 1891751582 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete street address where Kevin Clyde Potter is physically located?
The Kevin Clyde Potter is physically situated at the following address: 1804 Warden St, Eau Claire, WI, 54703.
What is Kevin Clyde Potter's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Kevin Clyde Potter is Dentist, and the taxonomy classification code that categorizes this area of expertise is 122300000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1891751582 to Kevin Clyde Potter?
The Centers for Medicare & Medicaid Services originally issued the 1891751582 to Kevin Clyde Potter on 2006-04-22.
When was the Kevin Clyde Potter's information last updated?
The Kevin Clyde Potter's information was last updated on 2007-07-08.