Henrichs, Kelly S

Henrichs, Kelly S is an individual health care provider with primary practice located at 100 W Ross Blvd Building 2 Suite C, Dodge City KS 67801-7216. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Henrichs, Kelly S can be contacted via phone (620) 225-6555.

Contact Information

Primary practice address
100 W Ross Blvd Building 2 Suite C Dodge City KS 67801-7216
Phone: (620) 225-6555
Fax: (620) 225-3058
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6207 Kansas

Profile Details

NPI number 1316911696
LBN Legal business name Henrichs, Kelly S
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316911696 NPPES
Kansas Other 008753 BLUE CROSS BLUE SHIELD
Kansas Other 6207 BLUE CROSS BLUE SHIELD
Kansas Other 882377 BLUE CROSS BLUE SHIELD

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