Individual
DR. SUSAN BERNADETTE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1211 DOLPHIN CT, WAUKESHA, WI 53186-1488
(262) 436-3363
Mailing address
1925 N 122ND ST, WAUWATOSA, WI 53226-2019
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
100583-15
WI
Other
Enumeration date
06/19/2017
Last updated
06/19/2017
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