Provider Demographics
NPI:1861614562
Name:HENSCHEL, MARC (DDS)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:HENSCHEL
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 1:6611 99TH ST
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4360
Mailing Address - Country:US
Mailing Address - Phone:718-896-4240
Mailing Address - Fax:718-275-1312
Practice Address - Street 1:6611 99TH ST
Practice Address - Street 2:SUITE 1E
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4360
Practice Address - Country:US
Practice Address - Phone:718-896-4240
Practice Address - Fax:718-275-1312
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0408171223G0001X
PADS043083122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice