Provider Demographics
NPI:1902874969
Name:HENKEL, ROBERT HAROLD (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HAROLD
Last Name:HENKEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-4921
Mailing Address - Country:US
Mailing Address - Phone:781-933-0422
Mailing Address - Fax:781-933-4216
Practice Address - Street 1:26 WARREN AVE
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-4921
Practice Address - Country:US
Practice Address - Phone:781-933-0422
Practice Address - Fax:781-933-4216
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA179181MA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice