| Thomas Kennedy, Dds Of Louisiana Ii, A Professional Dental Llc | |
|
1128 Pecanland Rd Ste 1 Monroe LA 71203-7019 | |
| (318) 450-3104 | |
| Not Available |
| Full Name | Thomas Kennedy, Dds Of Louisiana Ii, A Professional Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1128 Pecanland Rd, Monroe, Louisiana |
| Authorized Official Name and Position | Haley Wooster (ENROLLMENT SPECIALIST) |
| Authorized Official Contact | 7127338551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas Kennedy, Dds Of Louisiana Ii, A Professional Dental Llc 1128 Pecanland Rd Ste 1 Monroe LA 71203-7019 Ph: (318) 450-3104 | Thomas Kennedy, Dds Of Louisiana Ii, A Professional Dental Llc 1128 Pecanland Rd Ste 1 Monroe LA 71203-7019 Ph: (318) 450-3104 |
| NPI Number | 1629466511 |
|---|---|
| Provider Enumeration Date | 12/31/2014 |
| Last Update Date | 11/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629466511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6219 (Louisiana) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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