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General NPI Number Information
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NPI Number | 1275917916
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Entity Type | Organization
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Legal Business Name | ROY D JENNINGS DDS PA
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 2208 COMMERCE DR
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City | MONROE
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State | NC
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Zip | 28110-6725
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Country | US
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Telephone | 704-283-2998
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Fax | 704-283-6883
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Provider Business Mailing Address
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Address Line | 2208 COMMERCE DR
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City | MONROE
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State | NC
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Zip | 28110-6725
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Country | US
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Telephone | 704-283-2998
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Fax | 704-283-6883
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Authorized Official
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Title or Position | DENTIST/MEMBER
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Name | DR. ROY D JENNINGS JR.
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Credential | DDS
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Telephone | 919-649-6893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7994
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License Number State | NC
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