Provider Demographics
NPI:1518267178
Name:KENNEDY, DANIEL LLOYD (BDS, DCLINDENT)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LLOYD
Last Name:KENNEDY
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Gender:M
Credentials:BDS, DCLINDENT
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Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:CHILDREN'S HOSPITAL BOSTON - DEPARTMENT OF DENTISTRY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-8702
Mailing Address - Fax:617-730-0448
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:CHILDREN'S HOSPITAL BOSTON - DEPARTMENT OF DENTISTRY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-8702
Practice Address - Fax:617-730-0448
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MADL111281223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics