Individual
BRADLEY JOSEPH HENKENIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
710 N BEAVER ST, BLDG 1, FLAGSTAFF, AZ 86001-3100
(928) 774-0181
(928) 774-7510
Mailing address
1005 W BOULDER LN, FLAGSTAFF, AZ 86001-1126
(928) 774-9660
(928) 774-7510
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6514
AZ
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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