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General NPI Number Information
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NPI Number | 1629716659
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Entity Type | Organization
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Legal Business Name | JARED S. KENWOOD, DDS, PC
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Dates
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Enumeration Date | 05/20/2022
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | 301 OXFORD VALLEY RD STE 404A
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City | YARDLEY
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State | PA
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Zip | 19067-7710
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Country | US
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Telephone | 215-493-1616
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Fax |
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Provider Business Mailing Address
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Address Line | 301 OXFORD VALLEY RD STE 404A
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City | YARDLEY
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State | PA
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Zip | 19067-7710
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Country | US
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Telephone | 215-493-1616
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JARED S KENWOOD
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Credential | DDS
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Telephone | 215-493-1616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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