Provider Demographics
NPI:1093734337
Name:HENSON, JAMES ALLEN JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALLEN
Last Name:HENSON
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1690 POWDER SPRINGS RD SW
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-4844
Mailing Address - Country:US
Mailing Address - Phone:770-422-9925
Mailing Address - Fax:770-499-0706
Practice Address - Street 1:1690 POWDER SPRINGS RD SW
Practice Address - Street 2:SUITE 210
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4844
Practice Address - Country:US
Practice Address - Phone:770-422-9925
Practice Address - Fax:770-499-0706
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA93141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice