Provider Demographics
NPI:1871368266
Name:KENT, DANIEL EDWARD (MS3)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:EDWARD
Last Name:KENT
Suffix:
Gender:M
Credentials:MS3
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MONTEBELLO RD APT 1
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2461
Mailing Address - Country:US
Mailing Address - Phone:401-932-6794
Mailing Address - Fax:
Practice Address - Street 1:30 MONTEBELLO RD APT 1
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2461
Practice Address - Country:US
Practice Address - Phone:401-932-6794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program