Provider Demographics
NPI:1891413266
Name:KENNEY, ADAM CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:CHRISTOPHER
Last Name:KENNEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 S MILLER LN STE B
Mailing Address - Street 2:
Mailing Address - City:CATOOSA
Mailing Address - State:OK
Mailing Address - Zip Code:74015-1539
Mailing Address - Country:US
Mailing Address - Phone:480-408-4835
Mailing Address - Fax:
Practice Address - Street 1:2036 S MILLER LN STE B
Practice Address - Street 2:
Practice Address - City:CATOOSA
Practice Address - State:OK
Practice Address - Zip Code:74015-1539
Practice Address - Country:US
Practice Address - Phone:918-937-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7647122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist