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General NPI Number Information
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NPI Number | 1285915611
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Entity Type | Individual
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Provider Name | KENDALL WILLIAM JAMES DMD
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Gender | Male
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Dates
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Enumeration Date | 08/30/2011
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 515 DELAWARE ST. SE 9-176 MOOS TOWER
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City | MINNEAPOLIS
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State | MN
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Zip | 55455
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Country | US
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Telephone | 612-624-6644
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Fax |
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Provider Business Mailing Address
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Address Line | 1060 27TH AVE SE APT F
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-2773
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Country | US
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Telephone | 612-624-3254
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Fax | 612-626-2655
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | TBP
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | S172
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License Number State | MN
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