| Kennedy Dental Llc | |
|
202 E 5th St Marysville OH 43040-1261 | |
| (937) 642-3434 | |
| (937) 642-6434 |
| Full Name | Kennedy Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 202 E 5th St, Marysville, Ohio |
| Authorized Official Name and Position | Larry D Kennedy (OWNER/PARTNER) |
| Authorized Official Contact | 9376423434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennedy Dental Llc 202 E 5th St Marysville OH 43040-1261 Ph: (937) 642-3434 | Kennedy Dental Llc 202 E 5th St Marysville OH 43040-1261 Ph: (937) 642-3434 |
| NPI Number | 1316031560 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 08/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316031560 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 17367 (Ohio) | Primary |
| 122300000X | Dentist | 17486 (Ohio) | Secondary |
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