Individual
KELLY S HENRICHS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
100 W ROSS BLVD, BUILDING 2 SUITE C, DODGE CITY, KS 67801-7216
(620) 225-6555
(620) 225-3058
Mailing address
100 W ROSS BLVD, BUILDING 2 SUITE C, DODGE CITY, KS 67801-7216
(620) 225-6555
(620) 225-3058
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6207
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008753
BLUE CROSS BLUE SHIELD
KS
01
—
6207
DELTA DENTAL
KS
01
—
882377
UNITED CONCORDIA
KS
Enumeration date
02/14/2006
Last updated
07/08/2007
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