Individual
DR. KENNETH JEROME DEACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9100 FRANKLIN SQUARE DR, EASTERN FAMILY RESOURCE CENTER DENTAL CLINIC, BALTIMORE, MD 21237-3903
(410) 887-6440
Mailing address
3525 RESOURCE DR, RANDALLSTOWN, MD 21133-4733
(410) 887-0613
(410) 887-0713
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8170
MD
Other
Enumeration date
05/16/2007
Last updated
12/20/2015
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