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Individual

MRS. ANNE B KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
1801 W WISCONSIN AVE, MILWAUKEE, WI 53233-2186
(414) 288-0762
(414) 288-0678
Mailing address
1801 W WISCONSIN AVE, 004, MILWAUKEE, WI 53201-1881
(414) 288-0762
(414) 288-0678

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2887016
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33810500
WI
Enumeration date
04/09/2008
Last updated
04/09/2008
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