Organization
CLARKSVILLE TONGUE TIE CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN KENNEDY JR. DDS (OWNER)
(931) 206-0852
Entity
Organization
Contact information
Practice address
590 FIRE STATION RD STE D, CLARKSVILLE, TN 37043-4076
(931) 444-3410
Mailing address
590 FIRE STATION RD STE D, CLARKSVILLE, TN 37043-4076
(931) 444-3410
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
NO INSURANCE
—
Enumeration date
07/05/2021
Last updated
07/05/2021
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