Individual
KIMBERLY KERNOHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1172 SALT MARSH CIR, PONTE VEDRA BEACH, FL 32082-2542
(904) 543-0537
Mailing address
1172 SALT MARSH CIR, PONTE VEDRA BEACH, FL 32082-2542
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
201322
CO
124Q00000X
Dental Hygienist
Primary
DH4047
FL
Other
Enumeration date
10/27/2012
Last updated
10/27/2012
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