Organization
LOUIS P. KENYON, DMD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS PETER KENYON DMD (PRESIDENT/OWNER)
(508) 758-4818
Entity
Organization
Contact information
Practice address
28 FAIRHAVEN RD., MATTAPOISETT, MA 02747
(508) 758-4818
(508) 758-1369
Mailing address
PO BOX 1734, MATTAPOISETT, MA 02739-0445
(508) 758-4818
(508) 758-1369
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15932
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27818
UNITED CONCORDIA
—
01
—
X10624
BLUE CROSS BLUE SHIELD
MA
Enumeration date
07/04/2006
Last updated
08/22/2020
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