HEATH HENDRICKSON MBR NPI 1083978316

NPI Information

HEATH HENDRICKSON MBR is a general practice dentist in Provo, UT. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. HEATH HENDRICKSON MBR NPI is 1083978316. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Wisdom Teeth Only.

The provider's business location address is:

2230 N UNIVERSITY PKWY STE 8A
PROVO, UT
ZIP 84604-702
Phone: (801) 370-0050

The provider's authorized official is Raymond Heath Hendrickson .
The authorized official title is Owner and has the following contact phone number (801) 370-0050.

The enumeration date for this NPI number is 7/2/2012 and was last updated on 7/2/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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