| Thomas Kennedy, Dds Of Louisiana Ii, A Professional Dental Llc | |
|
170 Northshore Blvd Ste B Slidell LA 70460-6820 | |
| (985) 500-3155 | |
| (985) 643-6987 |
| Full Name | Thomas Kennedy, Dds Of Louisiana Ii, A Professional Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 170 Northshore Blvd Ste B, Slidell, Louisiana |
| Authorized Official Name and Position | Haley Wooster (ENROLLMENT SPECIALIST) |
| Authorized Official Contact | 7127338551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas Kennedy, Dds Of Louisiana Ii, A Professional Dental Llc 170 Northshore Blvd Ste B Slidell LA 70460-6820 Ph: (985) 500-3155 | Thomas Kennedy, Dds Of Louisiana Ii, A Professional Dental Llc 170 Northshore Blvd Ste B Slidell LA 70460-6820 Ph: (985) 500-3155 |
| NPI Number | 1588170112 |
|---|---|
| Provider Enumeration Date | 12/19/2017 |
| Last Update Date | 11/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588170112 | NPI | - | NPPES |
| 1857688 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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