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Individual

MR. JOSHUA ALLEN HENNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
X2

Contact information

Practice address
4TH & INNER LOOP ROAD, BLDG 171, FORT IRWIN, CA 92310
(719) 526-5537
(719) 524-2843
Mailing address
1631 WETZEL AVE, BLDG 815, COLORADO SPRINGS, CO 80913-4095
(719) 526-5537
(719) 524-2843

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary

Other

Enumeration date
06/06/2016
Last updated
06/06/2016
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