Individual
MR. KENNETH ELMER DIDAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3007 CHARLESTOWN XING, SUITE #100, NEW ALBANY, IN 47150-9484
(812) 945-3829
(812) 945-3722
Mailing address
3007 CHARLESTOWN XING, SUITE #100, NEW ALBANY, IN 47150-9484
(812) 945-3829
(812) 945-3722
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008781
IN
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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