Individual
VINCENT ISAIAS HENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DENTAL HYGIENIST
Contact information
Practice address
501 SE HAAWTHORNE BLVD. STE 400, PORTLAND, OR 97214
(503) 823-4000
Mailing address
4102 SE 97TH AVE, PORTLAND, OR 97266-2650
(503) 922-9930
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H8922
OR
Other
Enumeration date
03/18/2025
Last updated
03/18/2025
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