Heath Hendrickson Mbr

NPI #1083978316 in Provo, Utah

Provider Information

NPI Number: 1083978316
Entity Type: Organization
Organization Name: Heath Hendrickson Mbr
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 2, 2012
Last Updated: Jul 2, 2012

Practice Location

Address: 2230 N UNIVERSITY PKWY STE 8A
City: Provo
State: Utah
ZIP Code: 84604-6702
Phone: (801) 370-0050

Authorized Official

Name: DR. RAYMOND HEATH HENDRICKSON, DDS
Title: OWNER
Phone: (801) 370-0050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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