Kenneth Childress, DDS
NPI #1912923475 in Ruidoso, New Mexico
Provider Information
- NPI Number
- 1912923475
- Entity Type
- Individual
- Name
- Kenneth Childress, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Jul 15, 2006
- Last Updated
- Apr 24, 2012
Practice Location
- Address
- 721 MECHEM DR
- Address 2
- SIERRA MALL #5
- City
- Ruidoso
- State
- New Mexico
- ZIP Code
- 88345-6911
- Phone
- (575) 257-0246
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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