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Individual

DR. TYLER JENSEN HENDRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
411 N CENTRAL AVE, SUITE 220, GLENDALE, CA 91203-2081
(818) 240-4555
Mailing address
411 N CENTRAL AVE, SUITE 220, GLENDALE, CA 91203-2081
(818) 240-4555

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
55384
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1508873167
CA
Enumeration date
07/07/2008
Last updated
07/07/2008
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