Provider Demographics
NPI:1306908801
Name:FEE, KEVIN M (DDS)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:M
Last Name:FEE
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 1:19 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2191
Mailing Address - Country:US
Mailing Address - Phone:630-232-0044
Mailing Address - Fax:630-232-0118
Practice Address - Street 1:19 S 4TH ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2191
Practice Address - Country:US
Practice Address - Phone:630-232-0044
Practice Address - Fax:630-232-0118
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A145551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice