Individual
BRUCE EDWARD KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
435 PINE ST, ROCHESTER, MI 48307-1933
(248) 652-9116
(248) 652-3136
Mailing address
4367 CREEKWOOD CT, ROCHESTER HILLS, MI 48306-4605
(248) 652-7754
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13236
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13236
DENTAL
MI
Enumeration date
01/18/2007
Last updated
07/08/2007
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