KENNETH JOHANNESEN

NORTHPORT, NY
NPI1477507754
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: NY  044235)
Enumeration Date2006-05-20
Last Update Date2007-07-12
Business Address
Dr. KENNETH JOHANNESEN DDS
79 MIDDLEVILLE RD DVAMC NORTHPORT (160)
NORTHPORT, NY 11768-2200
Phone number: 631-266-6057
Mailing Address
Dr. KENNETH JOHANNESEN DDS
79 MIDDLEVILLE RD
NORTHPORT, NY 11768-2200
Phone number:
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