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General NPI Number Information
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NPI Number | 1669695508
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Entity Type | Organization
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Legal Business Name | ROBERT LEE KENNEY DDS
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1206 LASKIN RD SUITE 251
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-5263
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Country | US
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Telephone | 757-428-8404
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Fax | 757-428-6805
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Provider Business Mailing Address
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Address Line | 1206 LASKIN RD SUITE 251
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-5263
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Country | US
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Telephone | 757-428-8404
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Fax | 757-428-6805
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | DR. ROBERT LEE KENNEY
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Credential | DDS
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Telephone | 757-428-8404
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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 | 0401007212
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License Number State | VA
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