Provider Demographics
NPI:1689467946
Name:KANE, MOLLY MAUREEN (DMD)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:MAUREEN
Last Name:KANE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10521 SANTA ANITA TER
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-6100
Mailing Address - Country:US
Mailing Address - Phone:860-287-5377
Mailing Address - Fax:
Practice Address - Street 1:29 BEE STREET MSC 507 DENTAL CLINICS ROOM 550
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-0001
Practice Address - Country:US
Practice Address - Phone:843-792-4907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC111001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice