NPI 1003079260

Ivan K Hendrickson, DDS

Practitioner Dentist St George, UT

Practice location

Address: 720 S River Rd STE B210, St George, UT 84790-5584
Phone: (435) 656-0507
Fax: (435) 656-3791

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 143297 (UT)

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Registry record

NPI: 1003079260
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Jul 2008
Record last updated: 6 Mar 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.