BRIAN LEROY HENNINGSEN

JEFFERSON CITY, MO
NPI1033158993
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: MO  013482)
Enumeration Date2006-06-06
Last Update Date2007-07-08
Business Address
Dr. BRIAN LEROY HENNINGSEN DDS
1600 B SOUTHWEST BLVD
JEFFERSON CITY, MO 65109
Phone number: 573-635-4852
Mailing Address
Dr. BRIAN LEROY HENNINGSEN DDS
1600 B SOUTHWEST BLVD
JEFFERSON CITY, MO 65109
Phone number: 573-635-4852