KENYON M FORT DDS

Dr KENYON M FORT DDS is a male medical professional, specializing in Oral Surgery. He graduated in 1989.

Contact

7135 DR M L KING JR ST N
ST PETERSBURG
FL
337025819

Tel: 7275255455

KENYON M FORT DDS Information

Npi 1396830741
Pac Id 4183644297
Professional Enrollment Id I20051205000602
Last Name FORT
First Name KENYON
Middle Name M
Suffix
Gender M
Credential DDS
Medical School Name OTHER
Graduation Year 1989
Primary Specialty ORAL SURGERY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name
Group Practice Pac Id
Number Of Group Practice Members
Line 1 Street Address 7135 DR M L KING JR ST N
Line 2 Street Address
Marker Of Address Line 2 Suppression
City ST PETERSBURG
State FL
Zip Code 337025819
Phone Number 7275255455
Hospital Affiliation Ccn 1 100032
Hospital Affiliation Lbn 1 BAYFRONT HEALTH - ST PETERSBURG
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment M

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