Provider Demographics
NPI:1669631586
Name:KENNEDY, AARON D (DMD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:D
Last Name:KENNEDY
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 1:8198 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:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN183031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice