| NPI | 1104658582 |
|---|---|
| Doing Business As | KENNETT DENTAL |
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA PARK Dentist 267-266-0423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-08-15 |