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Individual

DR. KEVON EARL RENNIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D

Contact information

Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-1029
(860) 679-2000
Mailing address
4873 BELLE TERRE PKWY, PALM COAST, FL 32137-8696
(646) 290-1706

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10805
CT
1223G0001X
General Practice Dentistry
DN1856061
MA
1223G0001X
General Practice Dentistry
Primary
DN21399
FL
390200000X
Student in an Organized Health Care Education/Training Program
10805
CT

Other

Enumeration date
04/29/2011
Last updated
01/18/2021
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