Individual
IVAN K HENDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
720 S RIVER RD STE B210, ST GEORGE, UT 84790-5584
(435) 656-0507
(435) 656-3791
Mailing address
720 S RIVER RD STE B210, ST GEORGE, UT 84790-5584
(435) 656-0507
(435) 656-3791
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
143297
UT
Other
Enumeration date
07/08/2008
Last updated
03/06/2013
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