Organization
DR. HEATH HENDRICKSON
Active
Other names
Wisdom Teeth Only
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEATH HENDRICKSON DDS (OWNER)
(801) 370-0050
Entity
Organization
Contact information
Practice address
2230 N UNIVERSITY PKWY, 8A, PROVO, UT 84604-1509
(801) 370-0050
(801) 370-9635
Mailing address
2230 N UNIVERSITY PKWY, 8A, PROVO, UT 84604-1509
(801) 370-0050
(801) 370-9635
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
51365979922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HT000004-001
—
UT
Enumeration date
08/16/2010
Last updated
08/16/2010
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