Organization
KENNEDY DENTAL OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY A. DILLON (ACCOUNT MANAGER)
(304) 744-9717
Entity
Organization
Contact information
Practice address
410 4TH AVE, MONTGOMERY, WV 25136-2105
(304) 442-2488
(304) 442-8835
Mailing address
410 4TH AVE, MONTGOMERY, WV 25136-2105
(304) 442-2488
(304) 442-8835
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/13/2006
Last updated
08/22/2020
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