Individual
TAYLOR KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2828 INTERNATIONAL CIR, SUITE 100, COLORADO SPRINGS, CO 80910-3127
(719) 632-5700
Mailing address
3205 N ACADEMY BLVD, STE 130, COLORADO SPRINGS, CO 80917-5147
(719) 632-5700
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DEN.00201915
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02675030
—
CO
Enumeration date
07/11/2016
Last updated
04/04/2017
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