| NPI | 1316031560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY D KENNEDY Owner/Partner 937-642-3434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 17367) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 17486) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2009-08-04 |