Organization
KENNEDY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD KENNEDY (OWNER/DENTIST)
(503) 289-0230
Entity
Organization
Contact information
Practice address
3506 N LOMBARD ST, PORTLAND, OR 97217-5902
(503) 289-0230
(503) 286-5055
Mailing address
3506 N LOMBARD ST, PORTLAND, OR 97217-5902
(503) 289-0230
(503) 286-5055
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6716
OR
Other
Enumeration date
09/11/2008
Last updated
10/30/2024
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