Individual
DR. BOBBY CARL KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1611 EXECUTIVE CT STE 200, SACRAMENTO, CA 95864-2648
(916) 487-5160
(916) 487-8332
Mailing address
1611 EXECUTIVE CT STE 200, SACRAMENTO, CA 95864-2648
(916) 487-5160
(916) 487-8332
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
35625
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B3562501
—
CA
Enumeration date
03/05/2007
Last updated
06/19/2008
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