Provider Demographics
NPI:1447329396
Name:MULMED, KEVIN EUGENE (DDS)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:EUGENE
Last Name:MULMED
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 1:3226 N. MILLER RD.
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6930
Mailing Address - Country:US
Mailing Address - Phone:480-994-1988
Mailing Address - Fax:480-994-0100
Practice Address - Street 1:3226 N MILLER RD
Practice Address - Street 2:SUITE 5
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6930
Practice Address - Country:US
Practice Address - Phone:480-994-1988
Practice Address - Fax:480-994-0100
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice