Individual
DR. BRAD R JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1115 S MAIN ST, FORT SCOTT, KS 66701-2651
(620) 223-4448
Mailing address
13849 MEADOW CIR, LEAWOOD, KS 66224-4565
(913) 685-3323
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
KS 7195
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100350890E
—
KS
Enumeration date
02/05/2007
Last updated
01/30/2014
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