Provider Demographics
NPI:1043438229
Name:MCGEE, KENNETH WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:WILLIAM
Last Name:MCGEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3019 SEMMES AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-3756
Mailing Address - Country:US
Mailing Address - Phone:804-230-6687
Mailing Address - Fax:
Practice Address - Street 1:24427 MUSSELLWHITE DR
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:VA
Practice Address - Zip Code:23891-2222
Practice Address - Country:US
Practice Address - Phone:804-834-2678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410296122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist