Individual
JUSTINE SARA KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 HARRISON BRIDGE RD STE D, SIMPSONVILLE, SC 29680-7133
(864) 962-3515
Mailing address
415 N GRAND AVE, PUEBLO, CO 81003-3111
(719) 562-4461
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11066
SC
1223G0001X
General Practice Dentistry
30-022644
OH
Other
Enumeration date
08/23/2007
Last updated
08/01/2025
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