Provider Demographics
NPI:1760457741
Name:HENRIE, SEAN P (DMD)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:P
Last Name:HENRIE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 LOOKOUT CT
Mailing Address - Street 2:
Mailing Address - City:HALLSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75650-3421
Mailing Address - Country:US
Mailing Address - Phone:928-713-0113
Mailing Address - Fax:
Practice Address - Street 1:100 FORREST TERRACE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-6804
Practice Address - Country:US
Practice Address - Phone:903-938-8315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41434122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist