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1033158993
BRIAN LEROY HENNINGSEN
JEFFERSON CITY, MO
NPI
1033158993
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: MO 013482)
Enumeration Date
2006-06-06
Last Update Date
2007-07-08
Business Address
Dr. BRIAN LEROY HENNINGSEN DDS
1600 B SOUTHWEST BLVD
JEFFERSON CITY, MO 65109
Phone number: 573-635-4852
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Mailing Address
Dr. BRIAN LEROY HENNINGSEN DDS
1600 B SOUTHWEST BLVD
JEFFERSON CITY, MO 65109
Phone number: 573-635-4852
Copy
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