Provider Demographics
NPI:1073172177
Name:KENDALL, RACHEL KARRA (DMD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:KARRA
Last Name:KENDALL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 LINCOLN WAY E
Mailing Address - Street 2:
Mailing Address - City:MC CONNELLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17233-1426
Mailing Address - Country:US
Mailing Address - Phone:717-485-3817
Mailing Address - Fax:
Practice Address - Street 1:214 LINCOLN WAY E
Practice Address - Street 2:
Practice Address - City:MC CONNELLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17233-1426
Practice Address - Country:US
Practice Address - Phone:717-485-3817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0421801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice