Provider Demographics
NPI:1932385259
Name:LOUNDERS, KENNETH W (DMD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:W
Last Name:LOUNDERS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-2904
Mailing Address - Country:US
Mailing Address - Phone:941-475-1185
Mailing Address - Fax:941-473-4102
Practice Address - Street 1:120 N INDIANA AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-2904
Practice Address - Country:US
Practice Address - Phone:941-475-1185
Practice Address - Fax:941-473-4102
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 12106122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist