Individual
ATHENA KENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2301 E ALLEGHENY AVE FL 2, PHILADELPHIA, PA 19134-4427
(215) 282-8000
Mailing address
1815 JFK BLVD APT 1112, PHILADELPHIA, PA 19103-1710
(954) 303-3161
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS042762
PA
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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