Organization
SHELIA Y KENNEBREW DDS., MS., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELIA YVETTE KENNEBREW HORTON DDS., MS (PERIODONTIST/OWNER)
(248) 552-1195
Entity
Organization
Contact information
Practice address
29556 SOUTHFIELD RD, SUITE 100, SOUTHFIELD, MI 48076-2021
(248) 552-1195
(248) 552-0980
Mailing address
29556 SOUTHFIELD RD, SUITE 100, SOUTHFIELD, MI 48076-2021
(248) 552-1195
(248) 552-0980
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D2901015296
MI
Other
Enumeration date
09/15/2015
Last updated
09/15/2015
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