Provider Demographics
NPI:1124123955
Name:DELANE, KEVIN REX (DDS)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:REX
Last Name:DELANE
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Gender:M
Credentials:DDS
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Mailing Address - Street 1:7517 CAMERON ROAD SUITE 107
Mailing Address - Street 2:LONGHORN DENTAL ASSOCIATES PC
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752
Mailing Address - Country:US
Mailing Address - Phone:512-371-1222
Mailing Address - Fax:512-371-3914
Practice Address - Street 1:16000 PARK VALLEY DR
Practice Address - Street 2:STE 100
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681
Practice Address - Country:US
Practice Address - Phone:512-733-8308
Practice Address - Fax:512-310-0451
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TX19420122300000X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics