Provider Demographics
NPI:1265505085
Name:KENNELL, ALAN F (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:F
Last Name:KENNELL
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:783 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2716
Mailing Address - Country:US
Mailing Address - Phone:603-524-7404
Mailing Address - Fax:603-524-7405
Practice Address - Street 1:783 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2716
Practice Address - Country:US
Practice Address - Phone:603-524-7404
Practice Address - Fax:603-524-7405
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH035191223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics