Individual
TIA KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
3502 CLOVERDALE RD, FLORENCE, AL 35633-1302
(256) 483-5936
Mailing address
3502 CLOVERDALE RD, FLORENCE, AL 35633-1302
(256) 483-5936
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5854
AL
Other
Enumeration date
11/09/2011
Last updated
10/08/2024
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