Individual
DR. GARY ALLEN HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1585 BERDAN ST, CUMBERLAND, WI 54829-8532
(715) 822-4851
(715) 822-4800
Mailing address
1585 BERDAN ST, CUMBERLAND, WI 54829-8532
(715) 822-4851
(715) 822-4800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3473WI
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33476200
—
WI
Enumeration date
09/17/2006
Last updated
07/08/2007
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