Provider Demographics
NPI:1578524872
Name:HENSON, GRETCHEN KATHLEEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:KATHLEEN
Last Name:HENSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 W. CYPRESS
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003
Mailing Address - Country:US
Mailing Address - Phone:646-543-7362
Mailing Address - Fax:
Practice Address - Street 1:7301 E. 2ND ST NCAH HEUSER PEDIATRIC DENTAL
Practice Address - Street 2:SUITE 300 - DENTAL
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251
Practice Address - Country:US
Practice Address - Phone:480-882-4388
Practice Address - Fax:480-946-6997
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0559391223P0221X
AZD49331223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry