Provider Demographics
NPI:1508915059
Name:KENNEY, WILLIAM MICHAEL (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:KENNEY
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:209 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047
Mailing Address - Country:US
Mailing Address - Phone:410-879-2460
Mailing Address - Fax:410-893-8309
Practice Address - Street 1:209 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047
Practice Address - Country:US
Practice Address - Phone:410-879-2460
Practice Address - Fax:410-893-8309
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD 4825122300000X
MDGA 4825207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology