Kenneth J King | Redding, CA • PECOS Search

Kenneth J King

Dentist

Dental Providers

1548 East St, Redding, CA 96001-1109

PECOS Enrollment

Based on the most recent information from CMS, provider Kenneth J King does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1164633145
Provider Type
Individual
Full Name
King, Kenneth J
Title
Dr.
Credential
DDS

Gender
Male
Sole Proprietor
Yes
Enumeration Date
5/24/2007
Last Updated
7/8/2007

Contact Information

Practice Location

1548 East St, Redding, CA 96001-1109

Unlisted Fax

Mailing Location

1548 East St, Redding, CA 96001-1109

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 122300000X Primary	Description Dentist Dental Providers	License 28016 California