Provider Demographics
NPI:1992744049
Name:MCMILLEN, KEVIN ALLEN (DDS)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ALLEN
Last Name:MCMILLEN
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 1:3823 OLD WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1860
Mailing Address - Country:US
Mailing Address - Phone:724-327-1636
Mailing Address - Fax:724-733-7177
Practice Address - Street 1:3823 OLD WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1860
Practice Address - Country:US
Practice Address - Phone:724-327-1636
Practice Address - Fax:724-733-7177
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030166L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist