Individual
KASEY HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1245 E SOUTHERN AVE STE 12, MESA, AZ 85204-5138
(208) 206-8628
Mailing address
4498 E DUBLIN ST, GILBERT, AZ 85295-5862
(208) 206-8628
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D-4856
ID
122300000X
Dentist
Primary
D010145
AZ
Other
Enumeration date
07/11/2017
Last updated
03/08/2023
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