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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