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General NPI Number Information
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NPI Number | 1396848909
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Entity Type | Organization
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Legal Business Name | DENVER D JENKINS JR DDS INC
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 14805 DETROIT AVE SUITE #300
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City | LAKEWOOD
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State | OH
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Zip | 44107
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Country | US
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Telephone | 216-221-0300
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Fax | 216-221-0308
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Provider Business Mailing Address
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Address Line | 14805 DETROIT AVE SUITE #300
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City | LAKEWOOD
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State | OH
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Zip | 44107
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Country | US
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Telephone | 216-221-0300
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Fax | 216-221-0308
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | DR. DENVER D JENKINS JR.
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Credential | DDS
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Telephone | 216-221-0300
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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 | 3019214
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License Number State | OH
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