Provider Demographics
NPI:1194930487
Name:KENNEY, LAWRENCE MCDONALD (DMD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:MCDONALD
Last Name:KENNEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 N MCKEAN ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4956
Mailing Address - Country:US
Mailing Address - Phone:724-282-4830
Mailing Address - Fax:724-282-2655
Practice Address - Street 1:348 N MCKEAN ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4956
Practice Address - Country:US
Practice Address - Phone:724-282-4830
Practice Address - Fax:724-282-2655
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020087L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005257690002Medicare ID - Type Unspecified