| Thomas Kennedy, Dds Of Missouri Ii, Llc | |
|
108 Cecil St Ste G Camdenton MO 65020-7066 | |
| (573) 317-1473 | |
| Not Available |
| Full Name | Thomas Kennedy, Dds Of Missouri Ii, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 108 Cecil St Ste G, Camdenton, Missouri |
| 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 Missouri Ii, Llc 108 Cecil St Ste G Camdenton MO 65020-7066 Ph: (573) 317-1473 | Thomas Kennedy, Dds Of Missouri Ii, Llc 108 Cecil St Ste G Camdenton MO 65020-7066 Ph: (573) 317-1473 |
| NPI Number | 1598947632 |
|---|---|
| Provider Enumeration Date | 11/30/2007 |
| Last Update Date | 11/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598947632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 011904 (Missouri) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Lake Dental Clinic Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1497 N State Highway 5, Camdenton, MO 65020 Phone: 573-346-7278 Fax: 573-346-2176 |