Organization
JERROLD A HENNES DDS MSD PC
Active
Other names
Shadowridge and Pomerado Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERROLD ALAN HENNES DDS MSD (ORTHODONTIST)
(760) 598-1707
Entity
Organization
Contact information
Practice address
1950 SHADOWRIDGE DRIVE, SUITE A, VISTA, CA 92083
(760) 598-1707
(760) 598-2907
Mailing address
1950 SHADOWRIDGE DRIVE, SUITE A, VISTA, CA 92083
(760) 598-1707
(760) 598-2907
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DI34494
CA
Other
Enumeration date
12/18/2006
Last updated
08/22/2020
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