| Jennifer A Kennedy Dds Llc | |
|
601 Broadway Ave Mattoon IL 61938-4340 | |
| (217) 235-0556 | |
| (217) 234-7243 |
| Full Name | Jennifer A Kennedy Dds Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 601 Broadway Ave, Mattoon, Illinois |
| Authorized Official Name and Position | Jennifer A Kennedy (DENTIST) |
| Authorized Official Contact | 2172350556 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer A Kennedy Dds Llc 601 Broadway Ave Mattoon IL 61938-4340 Ph: (217) 235-0556 | Jennifer A Kennedy Dds Llc 601 Broadway Ave Mattoon IL 61938-4340 Ph: (217) 235-0556 |
| NPI Number | 1992136345 |
|---|---|
| Provider Enumeration Date | 12/11/2013 |
| Last Update Date | 12/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992136345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019024517 (Illinois) | Primary |
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