Individual
KENNETH G. WITT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
14625 LEBANON RD, SUITE A, OLD HICKORY, TN 37138-4620
(615) 754-0406
(615) 754-0406
Mailing address
115 PENNSYLVANIA AVE, LEBANON, TN 37087-3411
(615) 754-0406
(615) 754-0406
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS4494
TN
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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