Individual
JESSICA ANN HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1016 NW NEWPORT AVE, BEND, OR 97703
(541) 389-1107
(541) 317-5958
Mailing address
1016 NW NEWPORT AVE, BEND, OR 97703
(541) 389-1107
(541) 317-5958
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D10117
OR
1223G0001X
General Practice Dentistry
Primary
D10117
OR
Other
Enumeration date
08/14/2014
Last updated
07/21/2022
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