Provider Demographics
NPI:1568948214
Name:KENER, CHESTER BITTER (DMD)
Entity Type:Individual
Prefix:
First Name:CHESTER
Middle Name:BITTER
Last Name:KENER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4169 BUSHNELL RD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3325
Mailing Address - Country:US
Mailing Address - Phone:208-240-5868
Mailing Address - Fax:
Practice Address - Street 1:13455 N LON ADAMS RD
Practice Address - Street 2:
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85653
Practice Address - Country:US
Practice Address - Phone:520-329-7456
Practice Address - Fax:520-989-9123
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD010127122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist