Individual
DR. MICHAEL SCOTT HENRIKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1313 E HERNDON AVE STE 104, FRESNO, CA 93720-3306
(559) 435-7993
Mailing address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
105633
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/21/2020
Last updated
07/18/2024
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