DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. KENNETH WAYNE BOURGEOIS, DDS

Active Sole Proprietor

DR. KENNETH WAYNE BOURGEOIS, DDS is a General Dentistry healthcare provider located in TAMUNING, Guam. NPI 1255561320 is currently active in the NPPES registry. Verify at CMS.

General Dentistry · TAMUNING, GU

Registration Details

NPI Number
1255561320
Provider Type
Individual
Gender
Male
NPI Issued
Jul 22, 2009 (17.03048447915 yrs)
Last Updated
Jul 22, 2009
Licenses
D927 (GU)
14605 (TX)
Sole Proprietor
Yes

Practice Information

Address
226 CHALAN SAN ANTONIO STE C
TAMUNING, GU, 969133525
Browse GU providers · Browse ZIP 96913
Phone
6716462010
Fax
6716462070
Primary Specialty
General Dentistry
1223G0001X
Additional Specialty
General Dentistry

Other General Dentistry Providers in TAMUNING, GU

Name Credential NPI
DR. TIMOTHY P. BRADY D.D.S. 1225050529
DR. WAYNE WARD DDS. 1801915673
DR. JONATHAN VISSCHER D.D.S. 1053560565
DR. STANLEY YORK YASUHIRO D.D.S. 1598903023
DR. TOM SERAFICA VELORIA D.M.D. 1821329285
DR. SARAH LEE CLEGG D.D.S 1457764417
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.