Provider Demographics
NPI:1033287008
Name:GUFFEY, KENNETH C (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:C
Last Name:GUFFEY
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 ADAMS ST SE STE 215
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3759
Mailing Address - Country:US
Mailing Address - Phone:256-265-4950
Mailing Address - Fax:256-265-4949
Practice Address - Street 1:910 ADAMS ST SE STE 215
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3759
Practice Address - Country:US
Practice Address - Phone:256-265-4950
Practice Address - Fax:256-265-4949
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL54101223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery