Healthcare Provider Details

I. General information

NPI: 1154673846
Provider Name (Legal Business Name): DR FRANK KENDRICK DMD-HUNTERSVILLE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2012
Last Update Date: 10/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9625 NORTHCROSS CENTER CT SUITE: 101
HUNTERSVILLE NC
28078-7348
US

IV. Provider business mailing address

9625 NORTHCROSS CENTER CT SUITE: 101
HUNTERSVILLE NC
28078-7348
US

V. Phone/Fax

Practice location:
  • Phone: 704-875-9075
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number7221
License Number StateNC

VIII. Authorized Official

Name: MRS. YAIMARA DIAZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 704-875-9075