Healthcare Provider Details
I. General information
NPI: 1467768580
Provider Name (Legal Business Name): FRANK KENDRICK DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/26/2010
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8631 ARBOR CREEK DR STE D3
CHARLOTTE NC
28269-0548
US
IV. Provider business mailing address
8631 ARBOR CREEK DR STE D3
CHARLOTTE NC
28269-0548
US
V. Phone/Fax
- Phone: 704-875-9075
- Fax: 704-875-9055
- Phone: 704-875-9075
- Fax: 704-875-9055
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
FRANK
KENDRICK
JR.
Title or Position: DENTIST & OWNER
Credential: DMD
Phone: 704-875-9075