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Organization
BRADLEY J HENKENIUS, DDS, PC
Active
Organization
BRADLEY J HENKENIUS, DDS, PC
Active
Other names
Village Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY J HENKENIUS DDS (OWNER/PRESIDENT)
(928) 774-0181
Entity
Organization
Contact information
Practice address
710 N BEAVER ST BLDG 1, FLAGSTAFF, AZ 86001-3100
(928) 774-0181
(928) 774-7510
Mailing address
710 N BEAVER ST BLDG 1, FLAGSTAFF, AZ 86001-3100
(928) 774-0181
(928) 774-7510
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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