Organization
JEFFREY L HENKEN DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY L HENKEN DDS (DENTIST OWNER)
(208) 365-5064
Entity
Organization
Contact information
Practice address
1020 E LOCUST, EMMETT, ID 83617
(208) 365-5064
(208) 365-4235
Mailing address
1020 E LOCUST, EMMETT, ID 83617
(208) 365-5064
(208) 365-4235
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010012438
BLUE SHIELD
ID
01
—
68726
BLUE CROSS
ID
Enumeration date
08/30/2006
Last updated
08/22/2020
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