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Organization
JENKINS FAMILY DENTISTRY
Active
Organization
JENKINS FAMILY DENTISTRY
Active
Other names
Fort Scott Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD JENKINS D.D.S (OWNER)
(620) 223-4448
Entity
Organization
Contact information
Practice address
1115 S MAIN ST, FORT SCOTT, KS 66701-2651
(620) 223-4448
(620) 223-9957
Mailing address
1115 S MAIN ST, FORT SCOTT, KS 66701-2651
(620) 223-4448
(620) 223-9957
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
7195
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100350890E
—
KS
Enumeration date
01/20/2014
Last updated
01/29/2014
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