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Jennifer A Kennedy Dds Llc
Dental Clinic/Center in Mattoon, Illinois
NPI 1992136345

Jennifer A Kennedy Dds Llc is a Dental Clinic/Center based in Mattoon, IL and is specialized in Dental. Jennifer A Kennedy Dds Llc practices in Mattoon, IL. The NPI Number for Jennifer A Kennedy Dds Llc is 1992136345 and holds a License No. 019024517 (Illinois).

The current practice location address for Jennifer A Kennedy Dds Llc is 601 Broadway Ave, Mattoon, IL and can be reached out via phone at 217-235-0556 and via fax at 217-234-7243.

Location: 601 Broadway Ave, Mattoon, IL, 61938-4340
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1992136345
Provider Name
Jennifer A Kennedy Dds Llc
Credential
Provider Entity Type
Organization
Address
601 Broadway Ave, Mattoon, IL, 61938-4340
Phone Number
217-235-0556
Fax Number
217-234-7243
Provider Enumeration Date
12/11/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
601 Broadway Ave
City
Mattoon
State
Illinois
Zip
61938-4340
Phone Number
217-235-0556
Fax Number
217-234-7243
person
Provider Business Mailing Address Details
Address
601 Broadway Ave
City
Mattoon
State
Illinois
Zip
61938-4340
Phone Number
217-235-0556
Fax Number
217-234-7243
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
019024517 (Illinois)
Definition
Definition to come...
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