Organization
KENNEDY DENTISTRY
Active
Other names
MAIN STREET DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
EWA PLATACZ (OFFICE MANAGER)
(623) 594-8100
Entity
Organization
Contact information
Practice address
4252 N VERRADO WAY STE 105, BUCKEYE, AZ 85396-7596
(623) 594-8100
(623) 594-8120
Mailing address
4252 N VERRADO WAY STE 105, BUCKEYE, AZ 85396-7596
(623) 594-8100
(623) 594-8120
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5910
AZ
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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