Individual
MICHAEL W HENNEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
574 WASHINGTON ST, ASHLAND, OR 97520-1682
(541) 482-0541
(541) 482-0542
Mailing address
574 WASHINGTON ST, ASHLAND, OR 97520-1682
(541) 482-0541
(541) 482-0542
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5466
OR
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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