Provider Demographics
NPI:1124845730
Name:JENNIFER W. KENDRICK DMD, LLC
Entity type:Organization
Organization Name:JENNIFER W. KENDRICK DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE/FINANCIAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:H
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-377-4204
Mailing Address - Street 1:718 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:GA
Mailing Address - Zip Code:39828-1607
Mailing Address - Country:US
Mailing Address - Phone:229-377-4204
Mailing Address - Fax:229-377-7753
Practice Address - Street 1:718 N BROAD ST
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:GA
Practice Address - Zip Code:39828-1607
Practice Address - Country:US
Practice Address - Phone:229-377-4204
Practice Address - Fax:229-377-7753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty