Individual
DR. JERROLD ALAN HENNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1950 SHADOWRIDGE DR # A, VISTA, CA 92081-9006
(760) 598-1707
(760) 598-2907
Mailing address
1950 SHADOWRIDGE DR # A, VISTA, CA 92081-9006
(760) 598-1707
(760) 598-2907
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
34494
CA
Other
Enumeration date
01/18/2021
Last updated
01/18/2021
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