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Individual

DR. KENNETH MARK HUSSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
320 E HOSPITAL RD, FORT EISENHOWER, GA 30905
(719) 787-5102
Mailing address
38801 ACADEMIC DRIVE, SUITE B AND C, FORT EISENHOWER, GA 30905
(719) 787-6927

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
58586
CA
1223P0300X
Periodontics
Primary
10458666-9921
UT

Other

Enumeration date
09/02/2009
Last updated
07/16/2025
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