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Organization
KEVON E. RENNIE DMD, P.A.
Active
Organization
KEVON E. RENNIE DMD, P.A.
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
KEVON E RENNIE DMD (OWNER)
(904) 495-0881
Entity
Organization
Contact information
Practice address
1747 US HIGHWAY 1 S, SAINT AUGUSTINE, FL 32084-4238
(904) 495-0881
(904) 824-9257
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
(315) 410-5531
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN21399
FL
Other
Enumeration date
03/30/2016
Last updated
03/30/2016
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