Individual
DR. JASON ROBERT KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1858 CREST RD, MARYVILLE, TN 37804-4305
(865) 977-7110
Mailing address
301 LAKE FOREST DR, KNOXVILLE, TN 37920-5146
(865) 577-0361
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
N/A (RESIDENT)
TN
Other
Enumeration date
08/29/2007
Last updated
06/04/2008
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