Individual
DR. E. BARRIE KENNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.,M.S.
Contact information
Practice address
100 MEDICAL PLZ, SUITE 320, LOS ANGELES, CA 90095-0001
(310) 206-6252
Mailing address
929 MALCOLM AVE, LOS ANGELES, CA 90024-3113
(310) 474-1188
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
28738
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28738
DENTAL LICENSE
CA
Enumeration date
09/27/2006
Last updated
07/08/2007
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