Individual
RAYMOND HEATH HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2230 N. UNIVERSITY PARKWAY, SUITE 8A, PROVO, UT 84604
(801) 370-0050
(801) 370-9635
Mailing address
2230 N UNIVERSITY PARKWAY, SUITE 8A, PROVO, UT 84604
(801) 370-0050
(801) 370-9635
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5136597-9922
UT
1223G0001X
General Practice Dentistry
51365979922
UT
Other
Enumeration date
08/02/2006
Last updated
09/13/2011
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