Provider Demographics
NPI:1508177932
Name:AARON KENNEDY, DMD, PL
Entity Type:Organization
Organization Name:AARON KENNEDY, DMD, PL
Other - Org Name:KENNEDY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:941-351-9900
Mailing Address - Street 1:8198 TOURIST CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34201-2000
Mailing Address - Country:US
Mailing Address - Phone:941-351-9900
Mailing Address - Fax:
Practice Address - Street 1:8198 TOURIST CENTER DR
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34201-2000
Practice Address - Country:US
Practice Address - Phone:941-351-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 18303122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty