Kennedy, Kevin Chambliss

Kennedy, Kevin Chambliss is an individual health care provider with primary practice located at 590 Fire Station Rd Ste C , Clarksville TN 37043-4016. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Kennedy, Kevin Chambliss can be contacted via phone (931) 648-9930.

Contact Information

Primary practice address
590 Fire Station Rd Ste C Clarksville TN 37043-4016
Phone: (931) 648-9930
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 9411 Tennessee

Profile Details

NPI number 1629399647
LBN Legal business name Kennedy, Kevin Chambliss
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2010
Last updated Jan 22nd, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629399647 NPPES
Tennessee MEDICAID 1527793

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