Individual
DR. KENNEDY WOOD MERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5855 W UTOPIA RD, MIDWESTERN UNIVERSITY DENTAL INSTITUTE, GLENDALE, AZ 85308-5251
(623) 806-7070
(623) 537-6013
Mailing address
5855 W UTOPIA RD, MIDWESTERN UNIVERSITY DENTAL INSTITUTE, GLENDALE, AZ 85308-5251
(623) 537-6080
(623) 537-6013
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D009344
AZ
122300000X
Dentist
DD1246
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00089243
—
NM
Enumeration date
05/17/2006
Last updated
12/09/2015
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