# KENNEDY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MAIN STREET DENTAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447649520
- **Authorized official:** EWA PLATACZ (OFFICE MANAGER)
- **Authorized official phone:** (623) 594-8100

## Contact information

- **Practice address:** 4252 N VERRADO WAY STE 105, BUCKEYE, AZ 85396-7596
- **Practice address phone:** (623) 594-8100
- **Practice address fax:** (623) 594-8120
- **Mailing address:** 4252 N VERRADO WAY STE 105, BUCKEYE, AZ 85396-7596
- **Mailing address phone:** (623) 594-8100
- **Mailing address fax:** (623) 594-8120

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5910 | AZ | Yes |

## Other

- **Enumeration date:** 01/13/2015
- **Last updated:** 01/13/2015