Most Relevant Information
Provider Data
| NPI Number: | 1003079260 |
| Provider Name: | IVAN K HENDRICKSON DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 143297 |
Most Important Dates
| Enumeration Date: | 07/08/2008 |
| Last Updated: | 03/06/2013 |
Provider Practice Location
720 S RIVER RD STE B210
ST GEORGE
UT
847905584
Practice Location Phone/Fax
| Phone: | 4356560507 |
| Fax: | 4356563791 |
Provider Mailing Location
720 S RIVER RD STE B210
ST GEORGE
UT
847905584
Provider Mailing Phone/Fax
| Phone: | 4356560507 |
| Fax: | 4356563791 |