Provider Demographics
NPI:1972694974
Name:CONFELD, KENT ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:ALAN
Last Name:CONFELD
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 1:3152 MINNEHAHA AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2774
Mailing Address - Country:US
Mailing Address - Phone:612-728-8888
Mailing Address - Fax:612-724-2737
Practice Address - Street 1:3152 MINNEHAHA AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-2774
Practice Address - Country:US
Practice Address - Phone:612-728-8888
Practice Address - Fax:612-724-2737
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN91211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice