Provider Demographics
NPI:1063620938
Name:DEUK, KEVIN (DMD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:DEUK
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 1:1240 E STATE ST
Mailing Address - Street 2:SUITE # 107
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-2153
Mailing Address - Country:US
Mailing Address - Phone:775-751-8300
Mailing Address - Fax:775-751-5998
Practice Address - Street 1:1240 E STATE ST
Practice Address - Street 2:SUITE # 107
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-2153
Practice Address - Country:US
Practice Address - Phone:775-751-8300
Practice Address - Fax:775-751-5998
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4163122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist