Individual
KENNETH L SCHENCK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4845 HIXSON PIKE STE A, HIXSON, TN 37343-4466
(423) 875-4812
(423) 875-4814
Mailing address
PO BOX 1446, HIXSON, TN 37343-5446
(423) 875-4812
(423) 875-4814
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS1883
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5440298
—
TN
Enumeration date
10/28/2005
Last updated
07/08/2007
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