Organization
CHET JENKINS IV PC
Active
Parent organization
SIGNATURE DENTAL PARTNERS LLC
Other names
Costa Verde Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
SIGNATURE DENTAL PARTNERS LLC
Authorized official
MELODY BENNION (DIRECTOR OF INTEGRATIONS)
(480) 234-8490
Entity
Organization
Contact information
Practice address
1320 HARRISON AVE NW, OLYMPIA, WA 98502-5349
(360) 943-5551
Mailing address
410 N 44TH ST STE 600, PHOENIX, AZ 85008-7616
(480) 234-8490
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/04/2025
Last updated
04/04/2025
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