| Organization Name: | JENKINS FAMILY DENTISTRY |
| NPI Number: | 1548682933 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRAD JENKINS (OWNER) |
| Mailing Address: | 1115 S Main St Fort Scott |
| State: | KS US |
| Postal Code: | 667012651 |
| Phone Number: | 6202234448 |
| Fax Number: | 6202239957 |
| NPI Enumeration Date: | 01/20/2014 |
| NPI Last Update Date: | 01/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 7195 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |