Individual
DR. JESSICA LYNN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D13801
MN
1223P0221X
Pediatric Dentistry
D13801
MN
1223P0221X
Pediatric Dentistry
Primary
DE60791472
WA
390200000X
Student in an Organized Health Care Education/Training Program
RR60541536
WA
Other
Enumeration date
05/04/2015
Last updated
06/25/2018
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