Kennelly, Margie

Kennelly, Margie is an individual health care provider with primary practice located at 8960 Springbrook Dr Nw Suite 150, Coon Rapids MN 55433-5852. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Kennelly, Margie can be contacted via phone (763) 784-7570.

Contact Information

Primary practice address
8960 Springbrook Dr Nw Suite 150 Coon Rapids MN 55433-5852
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D10224 Minnesota

Profile Details

NPI number 1205807427
LBN Legal business name Kennelly, Margie
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Feb 27th, 2012 - about 12 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 1205807427 NPPES
Minnesota MEDICAID 949815000

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