Individual
DR. TERRANCE DALE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2910 JENNY LIND ROAD, SUITE 7, FORT SMITH, AR 72901-6733
(479) 785-4107
(479) 494-7638
Mailing address
2910 JENNY LIND ROAD, SUITE 7, FORT SMITH, AR 72901-6733
(479) 785-4107
(479) 494-7638
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1955
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58316
BLUE CROSS FEDERAL
—
01
—
835361
BLUE CROSS STATE
AR
Enumeration date
10/26/2006
Last updated
07/08/2007
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