Provider Demographics
NPI:1679706733
Name:KAY, SEBRON E (DMD)
Entity type:Individual
Prefix:DR
First Name:SEBRON
Middle Name:E
Last Name:KAY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-4817
Mailing Address - Country:US
Mailing Address - Phone:321-452-5000
Mailing Address - Fax:321-452-5056
Practice Address - Street 1:307 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-4817
Practice Address - Country:US
Practice Address - Phone:321-452-5000
Practice Address - Fax:321-452-5056
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2924122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist