Organization
JENKINS FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD R JENKINS DDS (OWNER)
(785) 743-2481
Entity
Organization
Contact information
Practice address
531 RUSSELL, WAKEENEY, KS 67672
(785) 743-2481
(785) 743-5455
Mailing address
PO BOX 276, WAKEENEY, KS 67672
(785) 743-2481
(785) 743-5455
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7195
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116568
BLUE CROSS BLUE SHIELD
—
Enumeration date
08/24/2006
Last updated
08/22/2020
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