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Individual

DR. CONRAD B JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1138 ROSE HILL DR, CHARLOTTESVILLE, VA 22903-5128
(434) 972-6233
(434) 972-4310
Mailing address
PO BOX 7546, CHARLOTTESVILLE, VA 22906-7546
(434) 972-6233
(434) 972-4310

Taxonomy

Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
0401005559
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0013970
DORAL DENTAL
VA
Enumeration date
08/08/2006
Last updated
11/17/2008
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