Provider Demographics
NPI:1245374305
Name:FINN, KENNETH R (DMD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:R
Last Name:FINN
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:PO BOX 266
Mailing Address - Street 2:240 FARMS VILLAGE RD
Mailing Address - City:WEST SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06092-0266
Mailing Address - Country:US
Mailing Address - Phone:860-651-3542
Mailing Address - Fax:860-651-9958
Practice Address - Street 1:240 FARMS VILLAGE RD
Practice Address - Street 2:
Practice Address - City:WEST SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06092-0266
Practice Address - Country:US
Practice Address - Phone:860-651-3542
Practice Address - Fax:860-651-9958
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT59571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice