Individual
DR. JOHN MICHAEL KEARNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
610 YALE PL, CANON CITY, CO 81212-4611
(719) 275-4474
(719) 275-1010
Mailing address
610 YALE PL, CANON CITY, CO 81212-4611
(719) 275-4474
(719) 275-1010
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
HD1-00642
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
713135
UNITED CONCORDIA INSURANC
—
Enumeration date
04/27/2006
Last updated
07/08/2007
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