Provider Demographics
NPI:1407983224
Name:WINDLE, HENRY JOHN (DMD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:JOHN
Last Name:WINDLE
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 1:5060 TUSCARAWAS RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-1006
Mailing Address - Country:US
Mailing Address - Phone:724-495-3350
Mailing Address - Fax:724-495-6626
Practice Address - Street 1:5060 TUSCARAWAS RD
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-1006
Practice Address - Country:US
Practice Address - Phone:724-495-3350
Practice Address - Fax:724-495-6626
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0218531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice