| Brian L Henningsen Dds Pc | |
|
1600 Southwest Blvd # B Jefferson City MO 65109-2434 | |
| (573) 635-4852 | |
| Not Available |
| Full Name | Brian L Henningsen Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 1600 Southwest Blvd # B, Jefferson City, Missouri |
| Authorized Official Name and Position | Brian L Henningsen (OWNER) |
| Authorized Official Contact | 5736354852 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian L Henningsen Dds Pc 1600 Southwest Blvd # B Jefferson City MO 65109-2434 Ph: (573) 635-4852 | Brian L Henningsen Dds Pc 1600 Southwest Blvd # B Jefferson City MO 65109-2434 Ph: (573) 635-4852 |
| NPI Number | 1215099437 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215099437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 013482 (Missouri) | Primary |
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