| NPI | 1902003312 |
|---|---|
| Other Name | ALLENA WILLIS KENNERLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: DC DEN1000484) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 13861) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2007-07-08 |