Provider Demographics
NPI:1356797245
Name:HENRY, HOWARD (DDS, MSC)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:HENRY
Suffix:
Gender:M
Credentials:DDS, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11333 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5185
Mailing Address - Country:US
Mailing Address - Phone:480-367-8900
Mailing Address - Fax:
Practice Address - Street 1:11333 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 250
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5185
Practice Address - Country:US
Practice Address - Phone:480-367-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD024451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics