Individual
KAITLIN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1933 DELANCEY PL, PHILADELPHIA, PA 19103-6611
(215) 546-6111
Mailing address
1203 GERMANTOWN AVE APT A210, PHILADELPHIA, PA 19122-4490
(609) 923-2301
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.034214
IL
122300000X
Dentist
22DI03002400
NJ
122300000X
Dentist
Primary
DS044379
PA
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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