Provider Demographics
NPI:1093887242
Name:POMEROY, HENRY BRICK III (DMD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:BRICK
Last Name:POMEROY
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:H
Other - Middle Name:BRICK
Other - Last Name:POMEROY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:5201 AVENUE S
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-5641
Mailing Address - Country:US
Mailing Address - Phone:409-762-8884
Mailing Address - Fax:409-740-3038
Practice Address - Street 1:5201 AVENUE S
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-5641
Practice Address - Country:US
Practice Address - Phone:409-762-8884
Practice Address - Fax:409-740-3038
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX126881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice