Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KENNETH CLARK PRIDDY, DDS
ActiveDR. KENNETH CLARK PRIDDY, DDS is a Oral & Maxillofacial Surgery healthcare provider located in WENTZVILLE, Missouri. NPI 1598127672 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · WENTZVILLE, MO
Registration Details
- NPI Number
- 1598127672
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 28, 2016 (10.4221906575 yrs)
- Last Updated
- Jun 28, 2022
- Licenses
-
2021048521 (MO)9781 (KY)
Practice Information
- Address
-
853 MEDICAL DR STE 115WENTZVILLE, MO, 633853825Browse MO providers · Browse ZIP 63385
- Phone
- 6368873100
- Fax
- 6368873102
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
- Additional Specialty
- Oral & Maxillofacial Surgery
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.