Henrikson, Brett A
Henrikson, Brett A is an individual health care provider with primary practice located at 2 Executive Dr Ste A , Lafayette IN 47905-4859. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Henrikson, Brett A can be contacted via phone (765) 807-0230.Contact Information
Primary practice address
2 Executive Dr Ste A
Lafayette IN 47905-4859
Phone: (765) 807-0230
Fax: (765) 807-0234
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 12010155A | Indiana |
Profile Details
| NPI number | 1063629988 |
|---|---|
| LBN Legal business name | Henrikson, Brett A |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2007 |
| Last updated | Feb 24th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063629988 | NPPES |
| Indiana | MEDICAID | 200471200 |
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