Individual
DR. DAVID KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D. M.S.
Contact information
Practice address
255 HAVENWOOD DR, LAKE GENEVA, WI 53147-1988
(262) 248-0101
Mailing address
255 HAVENWOOD DR, LAKE GENEVA, WI 53147-1988
(262) 248-0101
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6951-15
WI
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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