Individual
DR. JOHN R HENDRICKS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
70 PENNINGTON DR STE 7, BLUFFTON, SC 29910-6056
(843) 706-3377
(843) 706-3381
Mailing address
10700 MEDLOCK BRIDGE RD, SUITE 202, DULUTH, GA 30097-8456
(770) 813-0079
(770) 814-7407
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
010491
GA
1223G0001X
General Practice Dentistry
Primary
9271
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
582014496
SEPERATE TAX ID #
GA
Enumeration date
04/11/2007
Last updated
01/28/2019
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