| Kennedy Dental Llc | |
|
3506 N Lombard St Portland OR 97217-5902 | |
| (503) 289-0230 | |
| (503) 286-5055 |
| Full Name | Kennedy Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3506 N Lombard St, Portland, Oregon |
| Authorized Official Name and Position | Gerald Kennedy (OWNER/DENTIST) |
| Authorized Official Contact | 5032890230 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennedy Dental Llc 3506 N Lombard St Portland OR 97217-5902 Ph: (503) 289-0230 | Kennedy Dental Llc 3506 N Lombard St Portland OR 97217-5902 Ph: (503) 289-0230 |
| NPI Number | 1003065251 |
|---|---|
| Provider Enumeration Date | 09/11/2008 |
| Last Update Date | 10/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003065251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D6716 (Oregon) | Primary |
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