Provider Demographics
NPI:1427171446
Name:KUNARD, KEVIN L (DDS)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:L
Last Name:KUNARD
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 1:33 FREMONT LAKE RD
Mailing Address - Street 2:P O BOX 803
Mailing Address - City:PINEDALE
Mailing Address - State:WY
Mailing Address - Zip Code:82941
Mailing Address - Country:US
Mailing Address - Phone:307-367-3700
Mailing Address - Fax:307-367-3701
Practice Address - Street 1:33 FREMONT LAKE RD
Practice Address - Street 2:
Practice Address - City:PINEDALE
Practice Address - State:WY
Practice Address - Zip Code:82941
Practice Address - Country:US
Practice Address - Phone:307-367-3700
Practice Address - Fax:307-367-3701
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYWY10361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice