Kennedy, Roselyn Brooks
Kennedy, Roselyn Brooks is an individual health care provider with primary practice located at 1400 Walter Reed Rd Ste 200, Fayetteville NC 28304-4411. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Kennedy, Roselyn Brooks can be contacted via phone (910) 864-9884.Contact Information
Primary practice address
1400 Walter Reed Rd Ste 200
Fayetteville NC 28304-4411
Phone: (910) 864-9884
Fax: (910) 354-1399
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 30019228 | Ohio |
| Dental Providers / Pediatric Dentistry | 1223P0221X | 8365 | North Carolina |
Profile Details
| NPI number | 1922214691 |
|---|---|
| LBN Legal business name | Kennedy, Roselyn Brooks |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2007 |
| Last updated | Feb 26th, 2009 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922214691 | NPPES |
| Ohio | MEDICAID | 0102838 |
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