Brett A Henrikson
Oral and Maxillofacial Surgeon
2 Executive Dr Ste A
Lafayette
, Indiana 47905-4859
Brett A Henrikson
Oral and Maxillofacial Surgeon
2 Executive Dr Ste A
Lafayette
, Indiana 47905-4859
(765) 807-0234
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Brett A Henrikson
- 2 Executive Dr Ste A
- Lafayette, IN
- Zip : 47905-4859
- Fax : (765) 807-0234
- Phone : (765) 807-0230
Second Address
- Brett A Henrikson
- 2 Executive Dr Ste A
- Lafayette, IN
- Zip : 47905-4859
- Fax : (765) 807-0234
- Phone : (765) 807-0230
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 12010155A | IN |
National Provider Identifier
| NPI | 1063629988 |
|---|---|
| Provider Name | Brett A Henrikson |
| First Address | Lafayette, IN 47905-4859 |
| Second Address | Lafayette, IN 47905-4859 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/05/2007 |
| Last Update Date | 24/02/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 200471200 | (05) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.