Organization
KKTZ
Active
Other names
Jennings & Larson Family Dentistry- Fort Mohave
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THADD JENNINGS DDS (MEMBER)
(928) 201-5588
Entity
Organization
Contact information
Practice address
5221 HWY 95 STE 4, FORT MOHAVE, AZ 86426-9244
(928) 577-2533
Mailing address
5221 HWY 95 STE 4, FORT MOHAVE, AZ 86426-9244
(928) 577-2533
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/28/2017
Last updated
12/28/2017
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