Provider Demographics
NPI:1962422121
Name:MARKLE, KENNETH FORD (DDS)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:FORD
Last Name:MARKLE
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 1:10723 N. OAK HILLS PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2862
Mailing Address - Country:US
Mailing Address - Phone:225-769-1444
Mailing Address - Fax:225-769-9939
Practice Address - Street 1:10723 N OAK HILLS PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2862
Practice Address - Country:US
Practice Address - Phone:225-769-1444
Practice Address - Fax:225-769-9939
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA47181223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics