| Organization Name: | KERRY KENDRICK, DDS, PLLC |
| NPI Number: | 1093004590 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KERRY L KENDRICK (OWNER/DENTIST) |
| Mailing Address: | 203 Chase Dr Hurricane |
| State: | WV US |
| Postal Code: | 255268938 |
| Phone Number: | 3047577792 |
| Fax Number: | 3047577808 |
| NPI Enumeration Date: | 04/05/2011 |
| NPI Last Update Date: | 04/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 3175 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |