Individual
JENNY MARIE HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, DT
Contact information
Practice address
918 MARKET ST, PERHAM, MN 56573-2118
(218) 346-7186
(218) 346-7182
Mailing address
918 MARKET ST, PERHAM, MN 56573-2118
(218) 346-7186
(218) 346-7182
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT99
MN
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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