Individual
MATTHEW C KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
1403 PETERMAN DR, ALEXANDRIA, LA 71301-3433
(318) 443-7208
(318) 443-0046
Mailing address
1403 PETERMAN DR, ALEXANDRIA, LA 71301-3433
(318) 443-7208
(318) 443-0046
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7042
NE
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7723
LA
Other
Enumeration date
07/11/2012
Last updated
05/14/2026
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