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Individual

DR. JERICK WILLIAM HENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1300 37TH AVE SW, MINOT, ND 58701-7240
(701) 852-5595
(701) 852-2669
Mailing address
1300 37TH AVE SW, MINOT, ND 58701-7240
(701) 852-5595
(701) 852-2669

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2223
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41311
ND
Enumeration date
06/17/2014
Last updated
06/17/2014
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