Individual
DR. BRUCE ORVAL KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1117 MAIN AVE, CRETE, NE 68333-2259
(402) 826-2488
(402) 826-4752
Mailing address
1117 MAIN AVE, CRETE, NE 68333-2259
(402) 826-2488
(402) 826-4752
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4325
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47055729400
—
NE
Enumeration date
07/27/2006
Last updated
07/08/2007
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