Provider Demographics
NPI:1184303745
Name:KVARFORDT, DEVON (DMD)
Entity type:Individual
Prefix:DR
First Name:DEVON
Middle Name:
Last Name:KVARFORDT
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 1:915 ALPER CENTER DR UNIT 25211
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-1551
Mailing Address - Country:US
Mailing Address - Phone:435-817-1133
Mailing Address - Fax:
Practice Address - Street 1:3501 N BUTLER AVE STE 104
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-6430
Practice Address - Country:US
Practice Address - Phone:505-564-4470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDB-2023-01741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice