Individual
DR. MICHAEL A KENDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
401 AVENUE OF THE CITIES, EAST MOLINE, IL 61244-4024
(309) 755-1700
(309) 755-1788
Mailing address
401 AVENUE OF THE CITIES, EAST MOLINE, IL 61244-4024
(309) 755-1700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.029862
IL
1223G0001X
General Practice Dentistry
09134
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019.029862
STATE LICENSE
IL
01
—
09134
STATE LIC
IA
Enumeration date
08/11/2014
Last updated
07/21/2022
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