Individual
DR. BRYAN NIKKILAS HENRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, JD
Contact information
Practice address
600 E US HIGHWAY 24, INDEPENDENCE, MO 64050-2910
(913) 424-8464
Mailing address
600 E US HIGHWAY 24, INDEPENDENCE, MO 64050-2910
(913) 424-8464
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2023044465
MO
Other
Enumeration date
06/14/2020
Last updated
12/01/2023
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